Hypoechoic thyroid nodules are one of the ultrasound manifestations of thyroid nodules. It is generally considered that hypoechoicity is a suspected malignant ultrasound feature, which can be clarified by thyroid puncture biopsy. If the diagnosis is benign and asymptomatic, the nodule can be followed up regularly; if the diagnosis is malignant, or if compression symptoms occur, surgery is usually required. In addition, when thyroid nodules are combined with abnormal thyroid function, medication is required. If thyroid nodules cause hyperthyroidism, anti-thyroid drugs such as methimazole or propylthiouracil may be needed for treatment; if thyroid nodules cause hypothyroidism, levothyroxine may be needed for treatment. Consultation with a medical professional is required before the use of medication. Patients with thyroid nodules are advised to consult a doctor for clarification of their condition and active diagnosis and treatment.