Grade 3 is a comprehensive ultrasound rating of thyroid nodules based on TIRADS, which mostly suggests a high likelihood of benignity and a very low rate of malignancy. However, when malignancy is present, it is usually treated with surgery. Thyroid nodules of TIRADS grade 3, despite the great possibility of benignity, should be treated with surgery as soon as malignancy is diagnosed to prevent further progression of the disease. In addition to the resection of the thyroid gland itself, the results of the lymph node examination should be combined to determine whether lymph node dissection is needed, as well as local external irradiation therapy to reduce the probability of tumor recurrence and prolong the patient’s survival. In addition, patients need to take levothyroxine tablets for lifelong replacement therapy after surgery. It is recommended that patients with grade 3 thyroid nodules and cancerous tumors should go to the hospital in time and under the guidance of the doctor for regular treatment.