Thyroid nodules (TNs) are common, affecting up to 50% of individuals, with most being benign but some malignant. The evaluation of TNs is crucial to rule out malignancy and determine the need for surgical intervention. This study aims to clarify the prevalence, types, assessment, diagnostic processes, current evaluation methods, and evidence-based management of TNs. TNs are typically discovered during physical exams or imaging procedures. Ultrasound is the preferred imaging method, and fine-needle aspiration (FNA) biopsy is essential for deciding whether surgery or surveillance is necessary. TNs with suspicious features on ultrasound may require cytologic analysis to assess malignancy risk. The management and treatment approach depends on FNA cytology results and ultrasound characteristics, ranging from follow-ups for low-risk cases to surgical intervention for high-risk patients. Clinicians should adopt a case-by-case, multidisciplinary approach based on current knowledge. The review also discusses the epidemiology, types of TNs, initial assessment, diagnostic studies, and management strategies, emphasizing the importance of accurate diagnosis and appropriate treatment to minimize unnecessary tests and costs.Thyroid nodules (TNs) are common, affecting up to 50% of individuals, with most being benign but some malignant. The evaluation of TNs is crucial to rule out malignancy and determine the need for surgical intervention. This study aims to clarify the prevalence, types, assessment, diagnostic processes, current evaluation methods, and evidence-based management of TNs. TNs are typically discovered during physical exams or imaging procedures. Ultrasound is the preferred imaging method, and fine-needle aspiration (FNA) biopsy is essential for deciding whether surgery or surveillance is necessary. TNs with suspicious features on ultrasound may require cytologic analysis to assess malignancy risk. The management and treatment approach depends on FNA cytology results and ultrasound characteristics, ranging from follow-ups for low-risk cases to surgical intervention for high-risk patients. Clinicians should adopt a case-by-case, multidisciplinary approach based on current knowledge. The review also discusses the epidemiology, types of TNs, initial assessment, diagnostic studies, and management strategies, emphasizing the importance of accurate diagnosis and appropriate treatment to minimize unnecessary tests and costs.