Aim: Aim of this study was to estimate the prevalence of thyroid malignancy in multinodular goiter cases and to describe the age, sex distribution, and pattern of thyroid malignancy in multinodular goiter. Materials and methods: A prospective cross-sectional study was carried out on multinodular goiter cases received for histopathologic examination in department of pathology from July 2015 to June 2017. A total of 100 cases were included in the study. Descriptive analysis was performed using frequencies and percentages. Results: Out of hundred patients operated for multinodular goiter, twelve patients had thyroid malignancy. Among 12 malignant cases, nine cases were papillary carcinoma and three were follicular carcinoma. Overall mean age of patients was 40 years. Mean age of patients with coexistent thyroid carcinoma was 39 years. Mean duration of goiter in those who had malignancy was 7.8 years, and that in those who had only goiter was 5.6 years. Overall male/female ratio was 6.14, and thyroid malignancy was seen in only females. Among papillary carcinoma, most common variant was microcarcinoma (four cases) followed by follicular variant (three cases) and conventional type (two cases). Conclusion: There is increased risk of thyroid carcinoma in multinodular goiter. Hence, total thyroidectomy is a better option to treat patients with multinodular goiter. Papillary carcinoma is more common than follicular carcinoma in multinodular goiter. Clinical significance: Total thyroidectomy is a better option to treat patients with multinodular goiter and, if treated conservatively, should be closely followed up.