Combined with the current medical situation in China, different diagnosis and treatment guidelines should be adopted according to the actual medical level of different regions and hospitals. Some large hospitals such as Beijing and Shanghai, which are in a position to do so, should align with the U.S. Guidelines for the Diagnosis and Treatment of Thyroid Nodules and Differentiated Thyroid Cancer as far as possible, relying mainly on ultrasonography and FNA cytology results to determine the need for surgical treatment, and intraoperatively guiding the scope of surgical resection based on frozen section results to avoid waste and damage caused by overtreatment. Large hospitals at provincial and municipal levels can rely mainly on the ultrasonographic features provided by ultrasonography for surgical selection, such as the presence of microcalcifications, hypoechoic solid nodules or nodules rich in blood, suggesting the possibility of malignancy can be operated directly, and intraoperative then judge the benignity and malignancy according to frozen section. If ultrasound diagnosis in the primary unit does not provide useful information, direct surgery can also be considered when the patient’s history and examination show the following: (1) previous radiation therapy to the head and neck; (2) family history of medullary thyroid carcinoma or multiple endocrine neoplasia type II; (3) age <15 years or >45 years; (4) single solid nodule in men; (5) symptoms such as hoarseness, dysphagia, and dyspnea. (6) fast-growing nodules; (7) hard nodules; (8) fixed nodules; (9) nodules >4 cm; (10) enlarged ipsilateral cervical lymph nodes. Cystic thyroid lesions are mostly benign and can be treated by simple aspiration. If the aspirated fluid is pure and clear, the nodules can be followed up for 6 months if they disappear completely; if the aspirated fluid is bloody, or if there are residual nodules after aspiration or if they recur soon after aspiration, surgery is indicated. If there are cancer cells or suspected cancer cells in the cystic fluid, surgery should be performed.