The evaluation of thyroid nodules begins with the fundamentals of clinical medicine: a focused history and physical examination, guided by current evidence-based guidelines and a broad understanding of thyroid pathologies. Proficiency in suspicious sonographic features is essential, and the ability to perform point-of-care ultrasound can further enhance clinical assessment by providing immediate, real-time data to inform management decisions-particularly in surgical planning. This chapter reviews the structural, functional, and cytologic evaluation of thyroid nodules, and discusses the role of ancillary testing in the setting of indeterminate cytology. Readers will gain a comprehensive, practical framework for the systematic workup of thyroid nodules, from initial presentation to definitive management.