We revisit the theory and phenomenology of scalar electroweak multiplet thermal dark matter. We derive the most general, renormalizable scalar potential, assuming the presence of the Standard Model Higgs doublet, $H$, and an electroweak multiplet $Phi$ of arbitrary SU(2$)_L$ rank and hypercharge, $Y$. We show that, in general, the $Phi$-$H$ Higgs portal interactions depend on three, rather than two independent couplings as has been previously considered in the literature. For the phenomenologically viable case of $Y=0$ multiplets, we focus on the septuplet and quintuplet cases, and consider the interplay of relic density and spin-independent direct detection cross section. We show that both the relic density and direct detection cross sections depend on a single linear combination of Higgs portal couplings, $lambda_{rm eff}$. For $lambda_{rm eff}sim mathcal{O}(1)$, present direct detection exclusion limits imply that the neutral component of a scalar electroweak multiplet would comprise a subdominant fraction of the observed DM relic density.