Thyroid nodules are common, usually asymptomatic, and often pose minimal risk to the affected patient. However, 10–15% prove malignant and serve as the rationale for diagnostic assessment. Safely identifying and treating a relevant thyroid cancer through a cost-effective process is the primary goal of the treating practitioner. Ultrasound is the principal means of initial nodule assessment and should be performed when any thyroid nodule is suspected. Fine-needle aspiration provides further cytological determination of benign or malignant disease and is generally applied to nodules larger than 1–2 cm in diameter, on the basis of holistic risk assessment.