Puncture does not rule out thyroid cancer, meaning that it is difficult to clarify the nature of the lesion with the results of the puncture and that there may be a risk of thyroid cancer. In general, when thyroid nodules reach a certain size and risk of malignancy, puncture biopsy is needed to further define the benign or malignant nature of the nodule. Currently, fine-needle aspiration biopsy is most commonly used, which has the advantage of being less invasive than coarse-needle aspiration and excisional biopsy. However, due to the small amount of material to be taken and the accuracy of the location of the material taken, it is still difficult to obtain a clear benign or malignant diagnosis for more than 30% of the patients. Puncture does not rule out thyroid cancer is an inconclusive diagnosis, indicating that the nature of the lesion is difficult to define by puncture and that there is still some risk of thyroid cancer. Follow-up or excisional biopsy is generally recommended, depending on the specifics of the lesion. Patients are advised to consult a specialist for further investigations and treatment as prescribed.