Increased volume of the thyroid gland with uneven parenchymal echogenicity may be caused by hyperthyroidism, thyroiditis, or thyroid nodules, and the specific treatment needs to be chosen according to the cause of the disease. 1. Hyperthyroidism: Hyperthyroidism is a disease in which the thyroid gland is hyperfunctional and the synthesis and secretion of thyroid hormones are increased. Patients with hyperthyroidism may have an ultrasound that reveals an increase in the size of the thyroid gland and an uneven parenchymal echogenicity, which can be treated with medications such as propylthiouracil, methylthiouracil, propranolol, or surgical treatment. 2. Thyroiditis: Patients with thyroiditis can also have increased thyroid volume and uneven parenchymal echogenicity, such as subacute thyroiditis and Hashimoto’s thyroiditis. Subacute thyroiditis is a painful thyroid disease associated with viral infections, and Hashimoto’s thyroiditis is a chronic autoimmune thyroid disease. For treatment, aspirin and ibuprofen can be used for the former, and levothyroxine can be used for the latter. 3. Thyroid nodules: Thyroid nodules are a kind of thyroid cell hyperplasia, the thyroid tissue in the limited mass of the disease, the patient will also appear in the thyroid gland volume increased, the substance of the performance of the echo is not uniform. For treatment, regular review of benign nodules is sufficient. Surgery may be considered if the nodule produces pressure symptoms or if cancerous nodules are suspected. If the examination reveals that the thyroid gland is enlarged and the parenchymal echogenicity is uneven, please follow the doctor’s instructions for treatment.