This retrospective case series looks at the use of teprotumumab in nine patients with thyroid eye disease (TED) of clinical activity score ≤one and >nine months duration, in an American cohort. Current European guidelines have suggested the use of teprotumumab for moderate to severe active TED where the patient has not responded or only partially responded to steroids. The study aims to look at a different group of patients to see if there is a role for this treatment in their care. The authors report a statistically significant post-treatment reduction in proptosis of 4.0 ±2.4mm in the worse affected eye and 3.0 ±1.9mm in the better eye. Teprotumumab did not have a significant effect on eyelid retraction, however. The paper investigates an interesting alternative to surgery for the rehabilitation of patients with proptosis related to chronic TED, but it remains to be seen if this will be cost-effective in government funded healthcare systems.