Medullary thyroid cancer (MTC) is a thyroid cancer. Compared to differentiated thyroid cancer, MTC differs in its management and prognosis. Appropriate management of this cancer is essential to achieve better disease outcomes. In this article, the Indian Society of Thyroid Surgeons guidelines panel members conferred and developed a consensus on various clinical questions and recommendations for optimal workup, treatment, and follow-up. Surgery is the mainstay treatment option in curative and even palliative settings. Newer systemic treatments and prophylactic surgeries hold promise for the future.