Thyroid nodules are a common clinical condition. According to the results of the first epidemiological survey of thyroid disease in China published by the Chinese Medical Association Endocrinology Branch, the prevalence of thyroid nodules in our population is as high as 18.6%. With the increase of people’s health care awareness and the popularity of health check-ups, the number of patients seeking medical consultation for asymptomatic thyroid nodules is increasing year by year. Meanwhile, thyroid cancer is one of the tumors with the fastest growing incidence. According to the 2012 China Tumor Registry Annual Report published by the National Tumor Registry, the average growth rate of thyroid cancer in China in the past 10 years is 14.2%, and the incidence rate is the 7th. Therefore, how to evaluate thyroid nodules and screen out malignant nodules is particularly important in clinical practice. Most thyroid nodules are benign nodules. They can be palpated clinically when they increase in size or when they are located in the isthmus of the thyroid gland. For nodules located in the dorsal thyroid gland or smaller nodules, a cervical ultrasound is required to detect them. High-frequency ultrasound is the most commonly used method to evaluate thyroid nodules and has the advantage of being convenient and non-invasive. Ultrasound can clarify the presence, size, location in the thyroid lobe, multiple or single nodules, as well as observe the echogenicity, margins and blood flow of the nodules, and understand whether they are calcified, among other things. Ultrasound examination can be used to analyze the ultrasound findings and provide an indication of the benignity or malignancy of the nodule. Fine needle aspiration cytology (FNA) of thyroid nodules is considered to be the most predictive technique before surgery and has been widely performed in Europe and the United States. What kind of nodules require fine needle aspiration cytology? FNA is a cytopathological examination with a sensitivity of 83% (65-98%) for the diagnosis of thyroid cancer and is a reliable method for the diagnosis of papillary, medullary and poorly differentiated cancers. Preoperative FNA helps to reduce unnecessary thyroid nodule surgery and helps to determine the appropriate treatment plan, FNA requires good thyroid ultrasound and surgical clinical skills and the cooperation of a high level pathologist. The Department of General Surgery of Tianjin Medical University General Hospital, with the support of the Department of Pathology, together with the Department of Endocrinology and the Department of Nuclear Medicine, has been the first to carry out this technology in the city and has completed nearly 100 cases with good results. About 10% of patients who present with thyroid nodules may have malignant thyroid disease, the most common being papillary thyroid cancer, which requires surgical treatment. Papillary thyroid cancer is a malignant tumor with good prognosis. With standard surgical treatment and postoperative isotope therapy and thyroid hormone suppression, more than 90% of patients can obtain a survival period of more than 20 years, in other words most patients can be cured. The main types of thyroidectomy for thyroid cancer include total thyroidectomy, subtotal thyroidectomy and thyroid lobectomy and isthmus. Total thyroidectomy is the removal of all thyroid tissue, with no visible thyroid tissue remaining; subtotal thyroidectomy is the removal of almost all visible thyroid tissue (preserving <1g of non-neoplastic thyroid tissue, such as the laryngeal nerve into the larynx or the parathyroid gland); lobectomy is limited to a single low-risk tumor less than 1cm. The lymph nodes around the thyroid gland are divided into central and lateral cervical lymph nodes, with prophylactic debridement of the central lymph nodes and therapeutic debridement of the lateral lymph nodes being advocated. Postoperatively, patients can be risk stratified based on pathological findings. Most patients with thyroid cancer require a combined treatment model of iodine 131 therapy and thyroid stimulating hormone suppression after surgery. Choosing a reasonable diagnostic method for evaluation of thyroid nodules, establishing an appropriate treatment plan, and performing a multidisciplinary comprehensive treatment including endocrine, general surgery, nuclear medicine and other disciplines are important to reduce patient suffering, improve treatment outcome and reduce treatment costs. In recent years, the development of molecular pathology, ultrasound technology, electrosurgery and minimally invasive technology, and the promotion of intraoperative neuromonitoring (IONM) technology have provided the technical guarantee for the management of thyroid nodules, but also put forward higher requirements. In 2012, the Chinese Society of Endocrinology, the Chinese Society of Surgery, the Head and Neck Tumor Committee of the Chinese Anti-Cancer Association, and the Chinese Society of Nuclear Medicine jointly formulated guidelines for the diagnosis and treatment of thyroid nodules and differentiated thyroid cancer. The Committee of Thyroid Surgeons of the Chinese Physician's Association Branch of Surgeons has also been established to promote standardized treatment of thyroid diseases. These are of great significance in standardizing the management of thyroid nodules, reducing controversies, and reducing medical risks.