Abstract: Background: Thyroid cancer is the second most common cause of mortality amongst endocrine malignancies, after ovarian cancer. Thyroid tumors that are differentiated account for around 95% of all thyroid malignancies. Thyroid cancer now outnumbers all other cancers in terms of occurrence. Objective: The study aimed to investigate the pattern of presentation and management of differentiated thyroid cancerat the National Cancer Institute in Wad Medani, Gezira State–Sudan. Methods: This is a retrospective descriptive hospital-based research that included all patients with differentiated thyroid carcinoma who presented to the National Cancer Institute Wad Medani between September 2016 and September 2020. The information is gathered using a standard structured data collection sheet and evaluated with SPSS for scientific class packaging for the social meaning of statistical packaging for social sciences version 24, USA. Results: Females 56 (76%) out of 74 patients with differentiated thyroid carcinoma at the National Cancer Institute Wad Medani had a male-to-female ratio of 1:3.2, and18 of them (24.3%) were in the 41-50 year age category. Sixty-nine (93.2%) of patients exhibited anterior neck swelling, whereas 15 (20.3%) reported shortness of breath. Sixty-six (89.2%) of patients had euthyroid status, and forty-nine (66.2%) had multinodular findings on ultrasonography, while the lateral compartment of lymph nodes was implicated in 8 (10.8 %) patients, the lateral and central compartments were engaged in 6 (8.1 %) patients, and the rest of the patients had no affected lymph nodes, 60 (81.1 %) had cold nodules on radioisotope scan, and 63 (85.1%) had cold nodules. Long-term goiter, which was reported in 20 of the research subjects, was the most prevalent risk factor (27 %).Papillary carcinoma is the most common histological form, accounting for 38.4% of all cases. Were 41(55%) with TNM stage-I. The scalp is the first site of metastases 6 (8.1%) in eighteen (24.3%) cases. The 38.4% of the patients had a total thyroidectomy, which was proceeded by radioactive iodine therapy in 47.4% of the cases. Conclusion: Early thyroid cancer identification is critical for effective management of differentiated thyroid carcinoma.