Thyroid nodules are common in clinical practice, with a prevalence of up to 60% depending on age and sex. Their management involves integrating laboratory, imaging, and pathology examinations to achieve an accurate diagnosis and avoid unnecessary therapeutic procedures. Key diagnostic tools include thyroid ultrasound (US), thyroid scintigraphy, fine-needle aspiration cytology (FNAC), molecular imaging, and artificial intelligence (AI). US scoring systems help differentiate benign from malignant nodules, while FNAC is recommended for suspicious findings. Thyroid scintigraphy is essential for detecting autonomously functioning nodules, which are rare in hyperfunctioning conditions. Molecular imaging with [99mTc]Tc-MIBI and [18F]FDG can help rule out malignancy in indeterminate cases, reducing the need for "diagnostic surgery." AI may improve the accuracy of these evaluations. The clinical impact of AI in thyroid nodule management requires further large-sample studies, especially for indeterminate cytology findings. The authors emphasize the importance of a multidisciplinary approach and standardized diagnostic protocols to optimize patient care.Thyroid nodules are common in clinical practice, with a prevalence of up to 60% depending on age and sex. Their management involves integrating laboratory, imaging, and pathology examinations to achieve an accurate diagnosis and avoid unnecessary therapeutic procedures. Key diagnostic tools include thyroid ultrasound (US), thyroid scintigraphy, fine-needle aspiration cytology (FNAC), molecular imaging, and artificial intelligence (AI). US scoring systems help differentiate benign from malignant nodules, while FNAC is recommended for suspicious findings. Thyroid scintigraphy is essential for detecting autonomously functioning nodules, which are rare in hyperfunctioning conditions. Molecular imaging with [99mTc]Tc-MIBI and [18F]FDG can help rule out malignancy in indeterminate cases, reducing the need for "diagnostic surgery." AI may improve the accuracy of these evaluations. The clinical impact of AI in thyroid nodule management requires further large-sample studies, especially for indeterminate cytology findings. The authors emphasize the importance of a multidisciplinary approach and standardized diagnostic protocols to optimize patient care.