Thyroid nodule category 4b, if the biopsy confirms benign can suspend surgery; if it is a malignant nodule or there is dyspnea and other compression symptoms, you need to operate in a timely manner, can not be delayed. Thyroid ultrasound TI-RADS classification is used to guide the diagnosis of thyroid nodules, which can grade the risk of malignancy of thyroid nodules (grade 0-6). Thyroid nodule category 4b is moderately suspicious of malignancy, and the risk of malignancy is 10%-50%, which requires fine-needle aspiration biopsy pathology examination to clarify the nature of the nodule. If the thyroid nodule is clearly benign, it can be left in surgery for the time being, with regular follow-up thyroid ultrasound to observe changes in the nodule. If the nodule is malignant, it needs timely surgical treatment and cannot be delayed, otherwise there may be metastasis and spread of malignant tumors; if the nodule is large in size and there are pressure symptoms such as dyspnea, it should be operated in time and cannot be delayed, otherwise it may be suffocated by worsening of dyspnea. Thyroid nodule category 4b need to go to the hospital as soon as possible, under the guidance of the doctor treatment.