Abstract： Objective To detect the efficiency of high resolution ultrasound in the differential diagnosis of benign and malignant thyroid nodules, to compare the vaule of high resolution ultrasound and ultrasound elastography in the differential diagnosis of benign and malignant tumors in thyroid nodules. Methods A total of 148 thyroid nodules from 123 patients were reviewed and analyzed by high resolution ultrasound and ultrasound elastography. With pathological findings as the golden diagnosis standard , using Logistic regression model, valuable indicators from the examination were screenrd.The sensitivity,specifi city,accuracy and Kappa of high resolution ultrasound were compared with ultrasound elastography in the defferential diagnosis of benign and malignant tumors in thyroid nodules. Results Logistic regression model showed echostruction,shape and calcification were independent risk factors of the differential diagnosis of benign and malignant under high resolution ultrasound Examination of thyroid nodules.The best diagnosis criteria of high resolution ultrasound met any four of eight indicators ,with sensitivity,specificity,accuracy and Kappa of 70.7%,78.1%,73.3%and 0.454 respectively. The diagnosis criteria of ultrasound elastography was the elasticity score ≥ 3, with sensitivity,specificity,accuracy and Kappa of 70.6%,90.0%,83.0%and 0.622 respectively. Conclusions Echostruction,shape and calcification were independent determinants of the differential diagnosis of benign and malignant under high resolution ultrasound Examination of thyroid nodules. The specificity and accuracy of ultrasound elastography are higher in the differential diagnosis of benign and malignant thyroid nodules,ultrasound elastography are more helpful to raising accuracy in defferential diagnosis of benign and malignant thyroid nodules combinated application of high resolution ultrasound Examination.