Immune therapies, such as checkpoint inhibitors, have revolutionized cancer treatment by producing dramatic and durable tumor responses in many types of advanced malignancies. Unfortunately, nearly two-thirds of patients treated with checkpoint inhibitor therapies will develop autoimmune disease in healthy tissues as an unwanted side effect. Endocrine organs (thyroid, pancreas, pituitary) are among the most commonly affected, and usually result in permanent tissue injury requiring life-long hormone replacement (e.g. insulin for ICI-diabetes). The clinical presentation and optimal management of these endocrine immune related adverse events (irAEs) are distinct from spontaneous autoimmune endocrinopathies, as reflected in changing practice guidelines. Furthermore, no treatments currently exist to prevent or reverse endocrine irAEs, but recent studies have shed light on the immune mechanisms and potential new therapeutic targets. With the expanding use of cancer immunotherapies, clinicians and researchers need to aware of this emerging class of endocrinopathies.