Central hypothyroidism is a state of thyroid hormone deficiency due to disorders of the pituitary gland, hypothalamus, or hypothalamic–pituitary portal circulation, often due to low thyrotropin-releasing hormone (TRH), insufficient stimulation of normal thyroid-stimulating hormone (TSH), or both. Over the recent decades, a number of advances have been made in the etiology and clinical management of central hypothyroidism, and our knowledge about central hypothyroidism has accumulated at a rapid pace. The recent publication of expert guidelines for the diagnosis and management of central hypothyroidism will be helped to improve understanding and standardize the management of this endocrine disorder.