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Ultrasonography (USG) is the best imaging modality for thyroid gland. By USG normal anatomical and pathological features of the abnormalities as in size, number of nodules, margin, composition and various characteristics of a lesion can be demonstrated and also helpful in invasive procedure like Fine needle aspiration (FNA) under USG guidance. Recently the American College of Radiology Thyroid Imaging Reporting And Data System (ACR TIRADS), a quantitative scoring system is published in white paper in which points are given for all the ultrasound features like the composition, echogenicity, shape, margin, echogenic foci within the nodule, with more suspicious features being awarded additional points.