If the aspect ratio of a thyroid nodule is greater than one, the nodule is not necessarily malignant, but only suggests that there may be a risk of malignancy, which needs to be evaluated in combination with other ultrasound indicators, and if necessary, a biopsy should be performed to determine the benignity or malignancy of the nodule. The main indicators for evaluating the benign or malignant nature of a nodule based on ultrasound results are: whether the echoes of the nodule are hypoechoic, hyperechoic, or moderately echogenic; whether the edges of the nodule are clear and whether there is a peripheral membrane; whether there is any calcification within the nodule; whether there is attenuation of echoes at the back of the nodule; whether the aspect ratio is greater than unity; and whether there is an abundance of blood supply in the nodule, and so on. Risk factors for malignancy of thyroid nodules include uneven internal echogenicity, unclear borders, absence or incompleteness of the peritoneum, calcification within the nodule, attenuation of echogenicity in the back of the nodule, abundant blood flow, and a longitudinal to transverse ratio of more than one, etc. If there is only a single nodule with a transverse ratio of more than one, it may be difficult to detect the malignancy. If the aspect ratio is greater than one, the nodule is not necessarily malignant. Prompt medical attention is recommended for thyroid nodules.