An uneven thyroid gland indicates an uneven density within the thyroid gland. It may be a mass in the thyroid gland, such as a nodular goiter or thyroid adenoma, or it may be a diffuse enlargement of the thyroid gland, such as primary hyperthyroidism. In the case of a nodule in the thyroid, ultrasonography is needed to further clarify. For small nodules, less than two centimeters, with no obvious symptoms of pressure, they can be followed up and do not require special treatment, but only need to be reviewed by ultrasound every six months. If the nodule is larger than three centimeters or if there are symptoms of pressure, surgery is required to remove the thyroid gland on the side with the lesion. If the enlarged thyroid gland is caused by hyperthyroidism and the thyroid function tests show a significant increase in T3 and T4 and a decrease in TSH, the patient should be treated with conservative medical therapy, such as oral tabazol or propylthiouracil, followed by a review of thyroid function and thyroid ultrasound. If medical treatment is not effective, thyroidectomy can be considered.