Thyroid eye disease (TED) can affect quality of life even in its mild form and can possibly lead to permanent disfigurement and visual loss. It poses significant health burden in terms of individuals and public. Accurate assessment, early recognition and timely referral are keys to successful management of TED. This presentation aims to go through various assessment tools, scoring systems for activity and severity so as to enable audience to be familiarize with basic elements of TED examination. Also it aims to discuss updates in the understandings of the pathophysiology in which development of novel treatments base on.