Thyroid nodules are a very common disease, especially in middle-aged women. Thyroid nodules are divided into two categories, benign and malignant, with benign nodules accounting for the majority and malignant nodules for less than 1%. A variety of clinical thyroid disorders, such as thyroid degeneration, inflammation, autoimmunity and neoplasia, can manifest as nodules. Thyroid nodules can be solitary or multiple, with multiple nodules having a higher incidence than solitary nodules, but solitary nodules have a higher incidence of thyroid cancer. Based on the pathology of nodules, they can be classified as: nodular goiter, inflammatory nodules, toxic nodular goiter, thyroid cysts, thyroid tumors, etc. Early recognition of the nature of thyroid nodules, especially the differentiation of benign or malignant lesions, is important for the choice of treatment options and prognosis. The nodules on the thyroid gland may be thyroid cancer, thyroid adenoma, nodular goiter and other causes. The determination of the benignity of thyroid nodules is based on medical history, physical examination, radionuclide scan, and aspiration cytology. In terms of history, 50% of nodules appearing in childhood are malignant, and a single nodule occurring in a young male should be alerted to the possibility of malignancy. On physical examination, multiple nodules are usually benign lesions, while thyroid cancer is mostly a single isolated nodule that is uneven to touch, hard in texture, and less mobile when swallowed, and sometimes even the enlarged lymph nodes in the ipsilateral neck can be palpated. On radionuclide scan, thyroid cancer is mostly “cold nodules” with faint margins. The nature of the nodule can be further clarified by puncture cytology, and the correct diagnosis rate of experienced pathologists can reach over 80%. Those with high suspicion of malignant disease should have the nodules surgically removed as soon as possible. Although multiple nodules or single adenomas are benign lesions, some patients may develop secondary hyperfunction or cancer, so early surgical treatment is also recommended.