The management of thyroid nodules is multi-disciplinary and involves head and neck surgeons, pathologists and radiologists. Ultrasound is easy to perform, widely available, does not involve ionizing radiation and is readily combined with fine needle aspiration cytology (FNAC). It is therefore an ideal investigation of choice for evaluating thyroid nodules. It evaluates specific features that help in identifying the nature of the nodule and FNAC helps in diagnostic accuracy. In addition, following treatment for thyroid cancer ultrasound provides a safe tool for disease surveillance. This paper discusses the role of ultrasound in the management of patients with thyroid cancer. International Cancer Imaging Society.