Evolution of immune check point inhibitors (ICPi) is a breakthrough in the management of metastatic carcinomas. ICPi include CTLA-4 inhibitor ipilimumab; PD-1 inhibitors and PDL-1 inhibitors. Recognition of endocrine complications following ICPi therapy requires a high index of suspicion. Thyroid dysfunction and hypophysitis are common endocrine consequences. Development of endocrine complications predicts favorable outcome. Those with pre-existing hypothyroidism may require increase in dose after initiation of ICPi therapy. Discontinuation of ICPi is not warranted unless patient is severely thyrotoxic.