Introduction: Thyroid nodules are very common and can occur in up to 50% of the adult population. Thyroid nodules can be single or multinodular and benign or malignant. Ultrasonography is often the initial investigative modality used in the detection and characterization of various thyroid nodules. Aim: To evaluate the diagnostic accuracy of HRSG in characterizing benign and malignant thyroid nodules by correlating the sonographic findings with pathological diagnosis as reference.