Objectives: Anaplastic thyroid carcinoma (ATC) is rare disease, accounting for 1 to 2% of all thyroid carcinomas. However, ATC presents with a rapid and lethal clinical course, and the mean survival time after diagnosis was reported approximately 4 months. Locoregional disease control is absolutely required for improvement of the prognosis of the patients with ATC. We investigated survival rate and locogerional recurrence in patients with ATC Methods:The data of ATC patient who underwent surgery at our institution between 2006 and 2016 were retrospectively reviewed, and 16 patients were enrolled. Curative resection was performed for all patients. Result:Of the 16 patients, 10 were initial cases, whereas 6 were diagnosed with ATC during cancer relapse. The mean age at time of ATC surgery was 70.5 years (range, 50-85 years). All patients excluding 1 case had surrounding organs invasion by ATC great vessels in 4, trachea or larynx in 8, esophagus or pharynx in 8, recurrent laryngeal nerve or vagal nerve in 9, other organs in 11. The 5 years disease-specific survival rate and 5 years locoregional control rate were 31.3% and 65% respectively. Twelve patients died the cause of death was distant metastasis in 8 patients, and locoregional and distant metastasis in 4. Four patients are alive without cancer relapse. Among the cases with locoregional recurrence within the dissection area, the lesion was located on the carotid artery after carotid artery resection and reconstruction in 1 patient, larynx after paritial laryngectomy in 1, deep fascia in 1, and mediastimun in 1. Conclusion:ATC presents as the rapid growth associated with surrounding organ invasion in the locoregional area, also associated with high frequency of distant metastasis. Without distant metastasis, locoregional disease control by complete resection is absolutely required for improvement of the prognosis of the patients with ATC.