Background: ThyroidEx is a 19-item self-reported outcome measure designed to evaluate the expectations related to thyroid surgery. This study intended to validate the Arabic version of the ThyroidEx and measure its reliability and applicability among Arabic-speaking patients undergoing total thyroidectomy. Methods: A prospective cohort study was conducted where the ThyroidEx questionnaire was translated into Arabic and culturally adapted. In contrast to the original study, we included only patients who underwent total thyroidectomy as it suits most of the questions within the measure, such as thyroid medications and hypocalcemia concerns, while those set to undergo hemithyroidectomy or completion thyroidectomy were excluded. Participants were asked to complete the Arabic ThyroidEx questionnaire before surgery and again after surgery. The internal consistency of the questionnaire was analyzed using Cronbach’s alpha. Results: Our study revealed that patient expectations regarding mood changes due to medication adjustments significantly increased after surgery, with a P-value of 0.012. While expectations about pain and fatigue remained consistent before and after surgery, there was a slight increase in the anticipation of fatigue postoperatively. Concerns about long-term medication use, side effects of thyroid medication, and cancer recurrence also heightened after surgery, reflecting growing patient anxiety in these areas. Conclusion: The findings underscore the importance of addressing mood changes, medication side effects, and long-term management in preoperative discussions. The significant shift in mood-related expectations and the stable reliability of the Arabic ThyroidEx questionnaire highlights its effectiveness in capturing patient concerns, which can guide better patient support and improve postoperative outcomes.