Thyroid autoimmunity occurs when the immune system reacts against thyroid cells after targeting them like any other “not-self” antigen. To define a thyroid autoimmune disorder is often difficult even if the presence of auto-antibodies and/or autoreactive lymphocytes is a common feature. Although the pathogenetic mechanism is poorly understood, increasing evidences indicate that apoptosis is one of the key process that leads to thyroid auto-immunity. Afterward, Th cytokines have been considered the regulator factors of the cell survival in thyroid autoimmunity. Understanding the cell response from the perspective of type 1 or type 2 cytokines could clarify the pathogenetic mechanism controlling thyroid autoimmunity and define new therapeutic approaches.