Type 2 amiodarone-induced thyrotoxicosis (AIT2) is a result of destructive thyroiditis and systemic release of thyroid hormones.1 In AIT2, corticosteroid therapy is recommended, however thionamides and Lugol’s iodide are ineffective.2,3 In those who have contraindications to steroids and/or require rapid reduction in thryoid hormone levels, plasmapheresis may be an option.3,4 We herein report a case of AIT2 in a 68-year-old man who required rapid and urgent control of his thyroid state to allow a partial hepatectomy to be safely performed to remove a hepatocellular carcinoma with radiological features suggestive of a high risk of rupture. Corticosteroids were relatively contraindicated in the perioperative setting. Therefore, total thyroidectomy was determined to be the most appropriate and definitive therapy to normalise his thyroid function in anticipation of hepatic resection. To achieve a rapid reduction in circulating thyroid hormones, plasmapheresis was successfully utilised as a bridge to thyroidectomy. A hemi-hepatectomy subsequently followed, without significant complications. Therefore, this case illustrates the utilitisation of plasmapheresis in a patient with severe thyrotoxicosis due to AIT2 preceding thyroidectomy. Features of this case are discussed, together with its implications, and a review of the relevant literature.