Lingual thyroid is an uncommon developmental anomaly and is the result of failure of the thyroid to descend from the foramen caecum to its prelaryngeal site. The lingual thyroid with a functioning thyroid gland in the neck is even more rare. In this report, we describe a 40-year-old female patient with a foreign body sensation and progressive dysphagia caused by ectopic lingual thyroid that is 5 x 4 x 3 cm in size. Here we present a patient with functional lingual thyroid gland who had had thyroidectomy 20 years ago. Lingual thyroid, which is like a malignant mass, was excised by external approach without complications.