〔Abstract〕 Objective To investigate the value of 2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules(Chinese thyroid imaging reporting and data system, C-TIRADS) and the combination with elastography technology in the diagnosis of thyroid nodules. Methods The gray-scale and elastic sonographic features of 117 thyroid nodules confirmed by postoperative pathological diagnosed were analyzed retrospectively. C-TIRADS was used to classify and evaluate the gray-scale image, the ultrasonic elastic characteristics combined with the C-TIRADS results to establish a joint diagnosis of thyroid nodules. Based on related pathological data, the diagnostic value of C-TIRADS and the joint diagnosis for thyroid nodule was statistically compared. Results The sensitivity, specificity, accuracy and AUC of C-TIRADS and the joint diagnosis for diagnosing thyroid nodules were 82.2%, 88.6%, 84.6%, 0.854 and 95.9%, 86.4%, 92.3%, 0.911. Compared with C-TIRADS alone, there were consistent elevations of the sensitivity, accuracy and AUC in the joint diagnosis, while the specificity slightly decreased(P<0.05). Conclusion C-TIRADS have a satisfied diagnostic value for thyroid nodules. The joint diagnosis by combining with elastography can further enhance ultrasound diagnosis.