Graves disease comprises a syndrome involving the thyroid, orbit and skin. The unifying components that tie together these anatomically diffuse manifestations remains uncertain as do the genetic and environmental factors initiating and propagating disease. The orbital process, termed thyroid- associated ophthalmopathy or Graves orbitopathy, is not effectively managed because we do not yet understand enough about its pathogenesis to develop specific and safe therapeutic agents. Moreover, we lack complete and robust pre-clinical models of Graves disease. In this brief review, I will attempt to discuss the potential targets to which new agents might be developed and others that are already available and could be utilized in clinical trails. The wide array of biological agents recently introduced to the marketplace and those currently under development offer an opportunity to identify productive treatment strategies for this vexing disease.