Abstract: The authors report a case of differentiated thyroid carcinoma with postoperative recurrence complicating active thyroid-associated ophthalmopathy. While continuing levothyroxine sodium, the patient underwent ¹³¹I therapy combined with glucocorticoids, ⁹⁹Tc-methylene diphosphonate, and targeted drugs as part of a comprehensive intervention, ultimately achieving a favorable prognosis. Based on a review of the literature, the authors aim to emphasize that clinicians should make flexible decisions according to the patient's specific condition, break through conventional therapeutic frameworks, and implement individualized treatment to maximize clinical benefits for the patient.