Based on the 6mmx5mm hypoechoic thyroid alone, it is usually not possible to directly determine whether treatment is needed, and it is necessary to combine with the thyroid function, location and other conditions, and the doctor will decide what kind of treatment to take. Routine ultrasound follow-up may be considered if there are no other signs of malignancy and there are no enlarged lymph nodes in the neck. According to the 2016 American Association of Clinical Endocrinologists’ Medical Guidelines for Clinical Practice in the Diagnosis and Treatment of Thyroid Nodules, thyroid risk assessment is not based on size, but is often based on the following ultrasound prompts: Low-risk lesions (malignant risk of approximately 1%): ultrasound characterization of a thyroid cystic component >50%, nodules with a gelatinous component may be accompanied by reflection artifacts that are strongly echogenic, such as the comet’s tail sign, and spongy nodules with an isoechoic grid-like pattern. Intermediate-risk lesions (malignancy risk of approximately 5% to 15%): Nodules ultrasonographically characterized as isoechoic nodules, or hypoechoic substantial nodules with regular margins accompanied by central angiogenesis, gross calcifications, ill-defined foci of strong echogenicity, and increased stiffness on elastography. High-risk lesions (malignancy risk of about 50% to 90%): nodules with ultrasound features of significant hyperechoic nodules, fine calcifications, irregular borders, height greater than width (mostly described as aspect ratio >1 in China), extraperitoneal growth, and suspicious localized lymph node enlargement. Hypoechoic thyroid nodules require more factors to be considered and are usually graded by TI-RADS. It is recommended to visit the hospital in a timely manner, and according to the comprehensive situation, the next management plan will be formulated by a specialist.