Preservation of the recurrent laryngeal nerve is vital during thyroid and parathyroid surgery. Non-recurrent laryngeal nerve is an extremely rare anatomic variation that the surgeon must be aware of during nerve exploration. In this case, we describe a 29-year-old female with history of a large thyroid goiter who underwent a total thyroidectomy. Her preoperative CT scan showed a retro-esophageal right subclavian artery. During surgery, the isthmus was transected and the left thyroid lobe approached first. The left recurrent laryngeal nerve was identified and traced superiorly to its larynx insertion. After preservation of inferior thyroid vessels and parathyroids, Berry's ligament was transected, releasing the left lobe. The right thyroid lobe was then approached and the recurrent laryngeal nerve was not identified at the traceho-esophageal groove. The large goiter extended from para-esophageal to pre-vertebral fascia limiting examination at the laryngeal entrance. The thyroid gland was reflected medially and revealed a nerve traveling toward the larynx. However, this nerve coursed laterally and superiorly, rather than inferiorly. Further dissection in the inferior-lateral aspect of the para-tracheal area revealed the vagus nerve, but no inferior recurrent laryngeal nerve. The superior thyroid vessels were ligated and the superior thyroid lobe reflected medially and inferiorly. After this, the previously isolated nerve was seen entering the larynx and consistent with a right non-recurrent laryngeal nerve. The inferior thyroid vessels were ligated, parathyroids preserved, and Berry's ligament transected to release the right lobe. PTH levels throughout surgery were normal. The patient tolerated the procedure without postoperative hoarseness or hypocalcemia.