Abstract: Evaluate the values of SPECT，serum TSH and ultrasonography in the diagnoses of benign and malignant thyroid nodules. Retrospective analysis of SPECT ，serum TSH，and ultrasonography results of 89 patients with 141 thyroid nodules. And the examination results were compared with the post-operative pathological findings. It has statistical significance when the P-value of the significance test is smaller than 0.05. On SPECT, malignant rate of the “cold” nodules was 35.3%,and increased accompanied with the raising of serum TSH level (P<0.05).The results image were corresponding to the serum TSH level.A high serum TSH level ofen appeared in the “cold” nodules and a low serum TSH level ofen appeared in the “hot” nodules (P<0.05).（2）The rate of malignant increased accompanied with the raising of serum TSH level (P<0.05). The serum TSH level in patient with malignant cold nodule is higher than patient with benign cold nodule (P<0.05), and the best diagnosis TSH level is 1.695 mIU/L with sensitivity and specificity 83.8% and 77.3%, respectively. The best diagnosis TSH level in patient with solid cold nodule is 1.675 mIU/L with sensitivity and specificity 83.3% and 100%,respectively.Therefor,TSH level has no diagnositic significance in patient with hot,warm,or cool nodules (P>0.05).The combination of thyroid imaging may help to evaluate the functions and the form of thyroid nodules, serum TSH and ultrasonography so that it plays an important role in the differentiation of benign and malignant thyroid nodules.