Thyroid orbitopathy is a complex disease that can produce severe functional and cosmetic complications. Prompt diagnosis and treatment during the active inflammatory phase is essential to decrease late sequels. Corticosteroids remain the main pillar in the treatment of the active phase. Other possibilities when steroids fail are radiotherapy, cyclosporine or new biological agents such as rituximab. Rehabilitative surgery can be performed to treat the functional and disfiguring sequels in the inactive phase. A review of the clinical manifestations, classifications and treatment, both medical and surgical, is presented.