Introduction Post-thyroidectomy haemorrhage is a rare but potentially fatal complication due to rapid airway compromise. While most events occur within 24 hours, delayed haemorrhage is uncommon and may be influenced by postoperative anticoagulation. The optimal timing for resumption of anticoagulant therapy remains unclear. Methods A case of delayed post-thyroidectomy haemorrhage in an anticoagulated patient is presented. A narrative review of the literature was performed to evaluate the incidence, risk factors, and timing of delayed haemorrhage following thyroidectomy, with particular focus on anticoagulant use. Results A 74-year-old male re-presented six days following total thyroidectomy with hoarseness and neck swelling after recommencement of apixaban on postoperative day two. The reported incidence of post-thyroidectomy haemorrhage is approximately 1.48%, with delayed haemorrhage occurring in approximately 0.5% of cases. Oral anticoagulant use is associated with significantly increased rates of delayed postoperative haematoma compared with non-anticoagulated patients. Additional risk factors include male sex, older age, bilateral surgery, and neck dissection. In contrast, postoperative VTE following thyroid surgery is rare, with Australian survey data reporting very low incidences and no fatal events. Conclusion Delayed post-thyroidectomy haemorrhage is an infrequent but serious complication. Given the low incidence of postoperative VTE, the timing of anticoagulation resumption should be individualised, particularly in high-risk patients, to minimise the risk of life-threatening cervical bleeding.