Abstract Objective To explore the value of ultrasonic elastography in diagnosis of thyroid nodules; methods 85 patients ( including 104 thyroid nodules) were examined by conventional ultrasound and ultrasound elastography, compared sensitivity, specificity, positive predictive value, and negative predictive value and diagnostic accuracy of two kinds of inspection methods. Results 78 benign nodules and 26 malignant nodules were confirmed by pathology after operation in 104 thyroid nodules, the sensitivity of ultrasonography in diagnosis of benign and malignant nodules was 61.5%, the specificity was 69.2%, the positive predictive value was 40%, the negative predictive value was 84.4%, the diagnostic accuracy was 67.3%; The sensitivity of ultrasound elastography in the diagnosis of benign and malignant nodules was 92.3%, the specificity was 91%, the positive predictive value was 77.4%, the negative predictive value was 97.3%, the diagnostic accuracy was 91.4%; Compared the statistical indicators, ultrasound elastography was superior to conventional ultrasonography, the difference had statistical significance. Conclusion Ultrasound elastography is a new imaging technique, it diagnosed thyroid nodules qualitatively according to hardness grade, greatly improve the accuracy of diagnosis, it improves the diagnostic accuracy, and it has important clinical value in the diagnosis of thyroid nodular disease.