With the improvement of our national health, the detection rate of thyroid nodules has increased significantly. Many people are found to have thyroid nodules during health check-ups, so they worry about going to the hospital for specialist consultation, ultrasound and laboratory tests, but often still fail to obtain a clear diagnosis and treatment plan. There are two key questions: 1. Is the nodule benign or malignant? 2. Is surgical treatment needed? These two questions are also the most frequently asked questions in my related consultations. First of all, the ultrasonographer will usually give a direct indication or suggest a puncture biopsy for a nodule with a typical performance; however, for a suspicious nodule with an unclear image performance (TI-RADS classification is mostly grade 3 or 4a), it needs to be reviewed periodically because it is developing and changing. Even if the puncture result is benign, it still needs to be rechecked in 3-6 months. Not to mention that puncture results are not guaranteed to be 100% accurate, and although some people cannot understand this, it is a scientific fact that there is a false negative rate of 10% or less under normal circumstances. Therefore, sometimes it is not possible to draw an immediate conclusion about the benignity or malignancy of a nodule, and we need to be patient and wait. The good thing is that even if a thyroid nodule is malignant or malignant, its development is quite slow, and as long as it is monitored regularly, there is usually no delay in its development. Secondly, with regard to surgery, nodules with a high suspicion of malignancy on ultrasound (TI-RADS grade 4c or 5) or confirmed malignancy by puncture should undoubtedly be treated surgically. However, for those nodules that show obvious benign signs on ultrasound but are relatively large and fast-growing, they should also be treated surgically, otherwise they can cause compression of vital organs. In contrast, surgery is unnecessary and should not be performed for those small nodules that have a low likelihood of malignancy because surgery does not resolve the problem of recurrence. I have seen outpatients who have had two surgeries on one side of the thyroid gland in close proximity to each other within a year, and the result was a recurrence, which causes physical trauma and psychological stress. There is also the issue of thyroid function tests. Most of the thyroid nodule patients have normal thyroid function tests. However, a few of them have a significant decrease in thyrotropin (TSH) or a mild increase in T3 or T4. These patients can be examined by nuclear thyroid imaging for functionally autonomous thyroid nodules, which are 100% benign and suitable for iodine-131 treatment, and may be exempted from surgery. In some patients with combined Hashimoto’s disease, the test results show a significant increase in TPO and TG antibodies, and if TSH is also high, it is recommended to take appropriate doses of Eugenol or Raltez to help stabilize the gland and nodules and reduce further hyperplasia. In addition, for nodules with definite or suspected medullary thyroid cancer diagnosed by puncture, blood calcitonin and parathyroid hormone should also be tested, and surgery should be performed as soon as possible.