Objective To explore the applicational value of thyroid imaging reporting and data system(TI-RADS) ultrasonographic stratification in diagnosing thyroid nodules. Methods A total of 263 patients with 524 thyroid nodules were evaluated by using TI-RADS ultrasonographic stratification, and the results were compared with pathologic diagnostic analysis. Results Benign nodules almost belong to TI-RADS 2,3 and TI-RADS 4A, malignant nodules are more common in TI-RADS 4B,5 and 6 category nodules. If thyroid nodules of TI-RADS 2,3 and 4A category were prediction of benign nodules, and TI-RADS 4, 5 and 6 category were prediction of malignant nodules, they were statistically significant differences(χ2 =298. 49, P<0. 01), the accuracy, sensitivity and specificity of TI-RADS in diagnosis of benign and malignant thyroid lesions were 93. 3% (489/524), 83.7% (67/80), 95.0% (422/444). Conclusions TI-RADS can be well used in diagnosis of thyroid nodules. The area under ROC curve was 0. 889.