The reason for not recommending puncture for thyroid nodules may be that the physician has already made a preliminary determination of the nature of the nodule through ultrasound and nail function tests, so that puncture is not necessary, or that the patient’s symptoms are consistent with the indications for surgery and a decision has been made to treat the nodule surgically, so that intraoperative pathological examination is sufficient at this time and puncture is not necessary. In addition, some patients may have certain contraindications, such as nodules that are too small for puncture, cardiac insufficiency or respiratory diseases that prevent them from lying down, psychiatric history that prevents them from cooperating, coagulation disorders, skin infections at the puncture site, and the presence of serious diseases such as severe infections, myocardial infarction, and stroke, etc. The doctor may also not recommend puncture for such patients. In addition, thyroid nodule puncture cytology is one of the most important methods for the diagnosis of thyroid nodules and is safe, less invasive, and has a high diagnostic accuracy, because thyroid nodules have a certain degree of malignancy, and some nodules are sometimes difficult to accurately assess their benignity or malignancy based on imaging alone. Therefore, except in cases where some doctors do not recommend nodule puncture, puncture can be considered in cases where malignancy is suspected and other indications are met to help diagnose the disease.