The primary goal of clinical diagnosis of thyroid nodular lesions is to determine whether the nodule is benign or malignant. Malignant lesions require immediate comprehensive treatment including surgery, while benign lesions can be treated conservatively or with elective surgery, or with regular follow-up. Due to the superficial location of the thyroid gland and the use of high-frequency color Doppler ultrasound, the localization and estimation of the size of thyroid nodules is significantly better than other methods. Its accuracy rate can reach more than 90%. In addition, in the color Doppler ultrasound diagnosis of thyroid nodules, the sonographic ultrasound signs of various lesions are crossed, and there are still no reliable diagnostic criteria for malignant nodules, which makes it easy to miss the diagnosis and make the diagnosis more difficult. When thyroid cancer is combined with thyroid adenoma, it often appears as a nodular goiter-like image, which is neither like thyroid cancer nor thyroid adenoma, making it difficult to diagnose and easy to misdiagnose. Therefore, for microscopic nodules and multiple nodules, the internal echogenicity and color flow distribution should be carefully observed, and whether they are accompanied by microcalcifications. In the examination of thyroid nodules, one should know whether there is enlargement of ipsilateral glandular lymph nodes. When the primary lesion is very small, there is a metastatic mass in the lymph nodes of the neck, and rich blood flow signal can often be detected in the enlarged lymph nodes of the neck metastasis, which is important for the diagnosis of thyroid cancer. The general physicians do not know enough about the complex pathological types within the nodules and the physical basis of ultrasound image formation. The ultrasound images of multi-source cross-sectional thyroid disorders need to be further explored and analyzed, and the ultrasound diagnosis should be performed with a comprehensive analysis of clinical data. When using ultrasound diagnosis, we should make full use of color Doppler ultrasound imaging to understand the extent of nodal lesions, the blood supply within the lesions, and microscopic nodules to increase the chances of surgical removal of tumors. Color Doppler can detect abundant blood flow signals around malignant nodules. Atypical lesions still need to be combined with other clinical tests, such as laboratory tests, isotopes, and MRI. Cases with high suspicion of thyroid malignancy can be followed up periodically, and if necessary, puncture biopsy can be performed, and the diagnosis still depends on pathological examination. This can improve the ultrasound diagnostic compliance rate of benign and malignant nodules, which is important for early diagnosis and treatment of malignant thyroid nodules, and improve the survival period and quality of life of patients. By comparing the image performance of color Doppler ultrasonography diagnosis of thyroid nodules with pathological diagnosis, color Doppler ultrasonography is the preferred adjunctive diagnostic tool for thyroid nodules.