The prevalence of thyroid nodules can be as high as 20% or more. Most thyroid nodules can be observed, and only some of them require surgery. Currently, the diagnosis of thyroid nodules mainly relies on ultrasound. Ultrasound findings of hypoechoic thyroid gland, accompanied by dense calcification, aspect ratio >1, confusing and abundant blood flow signals within the nodule, and border invasion with indistinct borders or crab foot sign should be considered as possible thyroid cancer. Nevertheless, some patients still undergo diagnostic thyroidectomy due to the suspicion of malignant thyroid nodules, and some patients have difficulty in formulating a reasonable treatment plan because the nature of the nodules cannot be determined before surgery. Ultrasound-guided thyroid aspiration technique involves using a biopsy needle to puncture into a suspected thyroid nodule under the guidance of ultrasound and remove some of the tissue for pathological examination to obtain a pathological diagnosis. While puncture biopsy is almost routine in Europe and the United States, it is difficult to perform in China, and some patients worry that puncture may cause spread of implants. In fact, this is all unnecessary worry. The results showed that the accuracy, sensitivity, specificity, predictive value of positive nodules, and predictive value of negative nodules were 94.7%, 89.5%, 100%, 100%, and 90.2%, respectively. and 90.2%, respectively. Diagnostic surgery could be avoided in 92.9% (13/14) of cases. Therefore, ultrasound-guided thyroid aspiration biopsy can be used as the first-line diagnostic method for thyroid nodules. The results of 997 ultrasound-guided thyroid puncture biopsies at the PLA General Hospital by Mingbo Zhang et al. also showed an accuracy of 98% compared to post-surgical examinations. According to the 2012 edition of the guidelines for the treatment of thyroid nodules in China, ultrasound-guided thyroid aspiration biopsy is the most sensitive and specific test for preoperative evaluation of benign and malignant thyroid nodules. Can thyroid puncture biopsy cause needle tract dissemination or metastasis? There is no information or data showing that thyroid puncture biopsy can cause tumor dissemination and metastasis, so thyroid puncture biopsy will not increase the risk of this category. During ultrasound examination, thyroid puncture biopsy is recommended for nodules with the following conditions: ① Solid hypoechoic nodules larger than 1 cm in diameter. ② A thyroid nodule of any size that is suspected on ultrasound to have extraperitoneal growth or metastasis in the cervical lymph nodes. ③ High risk factors for thyroid cancer: genetic factors, history of neck radiation therapy. ④ Nodules less than 10 mm in diameter but with signs associated with malignant lesions on ultrasound [hypoechoic and/or irregular borders, aspect ratio >1, microcalcifications or disturbances in the blood flow signal in the nodule]. ⑤ Thyroid nodules that have been observed to increase in size by more than 50% (diameter increase of more than 20%, absolute value of not less than 2 mm).