Thyroid nodule 4b, thyroid tissue biopsy is feasible to clarify the nature of the nodule. If the nodule is malignant or has obvious pressure symptoms, surgery is feasible. If the nodule is benign with no obvious discomfort and the thyroid function is normal, follow-up observation is sufficient. Thyroid nodule 4b refers to TIRADS grade 4b, suggesting that the nodule is moderately suspicious of malignancy, with a malignancy rate of 10% to 50%. Patients are advised to undergo ultrasound-guided fine-needle aspiration biopsy to clarify the benign or malignant nature of the nodule. If the biopsy shows a malignant nodule, or if there are choking, pain, and other compression symptoms, surgery may be an option. If the nodule is determined to be benign and there are no obvious uncomfortable symptoms, and the thyroid function is normal, surgery can be withheld for the time being, and the patient can be observed and followed up. Patients with thyroid nodule TIRADS grade 4b are advised to seek medical treatment in time and under the guidance of the doctor to avoid delayed condition.