The prevalence of thyroid nodules in children is lower than that in adults. The prevalence of thyroid nodules in children (diagnosed by ultrasound) was reported to be 7.04% in China, and multiple nodules accounted for 66.7%, with a male to female ratio of 1:1.4. The majority of malignant thyroid nodules in children are DTC (differentiated thyroid cancer) and about 5% are MTC (medullary thyroid carcinoma), and the incidence of thyroid cancer is higher in females than in males in children over 10 years of age. The evaluation of thyroid nodules in children, including history taking, physical examination, laboratory tests, imaging and FNAB, is basically the same as in adult patients. 86-100% sensitivity and 65-90% specificity of FNAB in diagnosing thyroid cancer in children. Treatment of thyroid nodules in children is also essentially the same as in adult patients. Surgery is the primary treatment for malignant/suspect malignant thyroid nodules in children. The management of thyroid nodules in children differs from that of adult patients in the following aspects: 1. CT of the neck should be performed with caution because high dose radiation exposure may increase the chance of malignancy in children with thyroid nodules. 2. The percentage of malignant thyroid nodules in children is higher than in adults, and the risk of malignancy is also present in “hot nodules” confirmed by thyroid nuclide imaging. Therefore, children with “hot nodules” should be further evaluated. Malignant nodules in children are usually multifocal and have a higher chance of lymph node metastasis and even distant metastasis. Therefore, total or near-total thyroidectomy and postoperative 131Ι therapy are recommended for a larger percentage of children with DTC. 4. If a child with thyroid nodules has a family history of MTC or MEN2, RET gene mutation testing is recommended. The incidence of MTC is significantly higher in mutation-positive patients. Such patients should undergo prophylactic total thyroidectomy at an age that depends on the risk of developing MTC (as assessed by the RET mutation locus). The long-term survival rate of DTC is more than 90%; the 5-year and 15-year survival rates of MTC are more than 85%, but the 30-year survival rate is lower (about 15%). The recurrence rate of thyroid cancer in children is about 10-35%.