Thyroid nodules are a common problem in clinical practice, caused by congenital anomalies, inflammatory pathologies, and tumors. Thyroid nodules are a common endocrine problem, and while most are benign, differentiating between benign and malignant nodules is crucial for appropriate patient management. Ultrasonography (US) is the primary imaging modality for evaluating thyroid nodules and has high sensitivity of detecting benign nodules but its accuracy in definitively diagnosing malignancy can vary. Even though Final diagnosis relies on FNAC and histopathology of surgical specimens, every patient with thyroid nodules are not candidate for FNAC and histopathology diagnosis. This study aims to assess the accuracy of ultrasound characterisation of thyroid nodules compared with FNAC to reduce non-eligible patients from the invasive FNAC and histopathology procedure and avoid unnecessary surgery. Objective: The objective of this study is to assess the diagnostic accuracy of ultrasound in the characterisation of thyroid nodules compared to the fine needle aspiration results in patients visiting Tibebe Ghion hospital for thyroid scanning from December to January 2026