Benign thyroid nodules cannot be operated blindly, but surgery can be considered in the following cases. In our clinical practice, on the one hand, a large number of benign thyroid nodules that do not need surgery are “over-operated”, resulting in a great waste of social medical resources; on the other hand, many patients with early thyroid cancer are missed or misdiagnosed and do not receive timely and standardized treatment. Thyroid surgery, including the indications for surgery, scope of surgery and post-operative treatment, is not uniform in China and can be said to be very diverse. For example, benign thyroid diseases such as nodular goiter should be operated or not, and how large or how many nodules should be operated. There are five major indications in various versions of the domestic textbooks. In clinical practice, a large number of these indications are not implemented, one by one analysis: the second post-sternal goiter and the fourth nodular goiter secondary to hyperfunction are clear guidelines, there is no objection to surgery; the first due to tracheal, esophageal or laryngeal nerve compression caused by clinical symptoms are clear guidelines but clinical is not rare; the third huge goiter affects life and workers, the question arises, how big is huge? How to measure and assess whether it affects life and work? In fact, nodules with a diameter of 4 or 5 centimeters rarely affect life and work; the fifth nodular goiter is suspected to have malignant changes. In clinical practice, most of the reasons for doctors to do thyroid surgery are far-fetched towards the fifth article. In fact, there is a clear pathologic (histologic or cytologic) basis for suspected malignant nodular goiter in the United States. There is a significant gap in the availability of pathology in China, but it is possible to broadly determine the benignity or malignancy of thyroid nodules on ultrasound diagnosis. The accuracy rate of preoperative ultrasound diagnosis of thyroid cancer by highly skilled ultrasonographers can reach 95%, which is even comparable to frozen pathological sections.