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ABSTRACT Background: Chronic urticaria (CU) is a common inflammatory skin disorder with an often unidentified etiology. Growing evidence suggests an autoimmune basis, particularly an association with thyroid dysfunction and thyroid autoimmunity. However, data from South Asian populations, including Bangladesh, remain limited. Objective: The objective of this study was to evaluate the association of thyroid dysfunction and thyroid autoimmunity among patients with CU and to explore associated demographic, clinical, and laboratory correlations. Methods: This cross-sectional study was conducted from January to June 2025 at a tertiary care hospital in Dhaka, Bangladesh. A total of 187 patients aged 5–60 years with CU of more than 6 weeks’ duration were enrolled. Demographic and clinical data were collected using a structured questionnaire. Laboratory investigations included thyroid function tests (thyroid-stimulating hormone [TSH], free T3, and free T4), thyroid autoantibodies (anti-thyroid peroxidase [anti-TPO], anti-thyroglobulin [anti-Tg], and TSH receptor antibody), serum immunoglobulin E (IgE), eosinophil count, and complete blood count. Statistical analysis was performed using SPSS version 23, with P < 0.05 considered statistically significant. Results: Abnormal thyroid function was observed in 51.33% of patients, with overt hypothyroidism being the most common abnormality (34.22%). Anti-TPO antibodies were positive in 67.01% and anti-Tg antibodies in 52.8% of the tested patients. Thyroid disorders and autoantibody positivity were significantly more common among females. Patients with thyroid disorders had higher eosinophil counts, and serum IgE levels were significantly elevated in anti-TPO-positive cases. Several clinical manifestations and comorbidities showed significant associations with thyroid disorders. Conclusion: CU is strongly associated with thyroid dysfunction and thyroid autoimmunity. Routine screening for thyroid abnormalities should be considered in patients with CU.