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Thyroid hemiagenesis is a rare congenital anomaly, in which one thyroid lobe fails to develop. Thyroid hemiagenesis is associated with thyroid diseases such as Graves' disease, Hashimoto's thyroiditis, colloidal goiter and thyroid follicular and papillary cancer. A 53-year-old female patient was diagnosed with a thyroid nodule on health examination. A 99mTc pertechnetate thyroid scan showed absent uptake in the left lobe and cold nodule on the right lobe of thyroid gland. By ultrasonography, we found hemiagenesis in the left thyroid gland and an irregular shaped thyroid nodule on the right lobe of thyroid gland. We performed ultrasonography guided fine needle aspiration and cytologic analysis showed indeterminate nature. Thyroidectomy was performed and finally diagnosed follicular carcinoma of thyroid gland. The authors report this case with a literature review.