Objective To evaluate clinical value of ultrasound elastography in the differential diagnosis of thyroid nodules.Methods The characteristics of 90 thyroid nodules were confirmed by pathology examination, whose characteristics of conventional ultrasound imaging and ultrasound elastography imaging were analyzed, retrospectively.Results Based on histopathological examination,66 nodules were diagnosed as benign nodules, while 24 nodules were diagnosed as malignant ones.Compared with benign thyroid nodules,irregular shape, ill-defined margins,microcalcification,ratio of anteroposterior/transverse>1,and ultrasound elasticity gradeⅢ -Ⅳ were highly predictive of malignant nodules.Elasticity grade Ⅲ-Ⅳ was highly predictive of malignancy,with the sensitivity and specificity of 95.45% and 87.50%,respectively.Conclusions Ultrasound elastography has higher value in differential diagnosis of benign and malignant thyroid nodules.