Thyroid ultrasound is commonly performed to evaluate thyroid nodules, which have a high prevalence but low malignancy rate. While thyroid cancer incidence is increasing worldwide, this is likely due to better detection methods and environmental factors rather than an actual rise in cases. Ultrasound can characterize nodules based on features like size, shape, margins, and vascularity. However, excessive detection of small nodules without suspicious features may lead to unnecessary biopsies. Standardized reporting and adequate examiner training are needed to maximize the benefits and minimize the harms of thyroid ultrasound screening.