Background: To compare the necessity between Fine-needle aspiration (FNA) biopsy and ultrasound examination in the diagnosis of different sizes of the thyroid nodules. Does the FNA biopsy have to do it all? Methods: A retrospective analysis was performed to 8352 thyroid patients who underwent thyroid operations between 2011 and 2016 in our hospital. Results: In FNA(+) group, the nodule was more smaller, the increment speed of the amount of operation increased more faster. In no FNA group, the increment speed decreased not obvious in nodules ≥10mm sub-group, but tremendous in both nodules 5mm-10mm sub-group and nodules ≤ 5mm sub-group no matter the nodules were malignant or benign. Over the six years, the total operation number increased, but operation of patients with nodules ≥10mm decreased slightly and operation of patients with nodules Conclusions: In thyroid nodules ≥10mm sub-group, there is no statistical difference between ultrasound diagnosis and biopsy. In nodules