Objective：To evaluate the value of ultrasound-guided minimally invasive biopsy in diagnosis of thyroid nodules. Methods：The records of 528 patients with thyroid nodules (a total of 591 nodules, diameters ranged from 0.4 to 1.5 cm with the average diameter of 0.76 cm) undergoing ultrasound-guided minimally invasive biopsy (Bard Access Systems), from Oct. 2008 to Apr. 2010, were retrospectively analyzed. Results：Of the 528 patients, the biopsy specimens were succeesfully obtained from 525 patients, and the success rate was 99.4% (525/528). There were 161 cases of thyroid carcinoma and 367 cases of benign lesion diagnosed by biopsy. A total of 226 cases underwent surgical treatment after biopsy and the postoperative pathological consistency rate was 98.7%, in which false negative rate was 1.3% (3/226), and no false positive cases were found. In 27 cases, preoperative cervical lymph node minimally invasive biopsy was performed at the same time, and their biopsy pathologies were completely consistent with the results of postoperative pathological examination. All patients had no apparent discomfort after biopsy except for hematoma occurring intramuscularly or on the surface of the gland in 22 cases, which spontaneously resolved after about 1 month without special treatment. Conclusions：Preoperative diagnosis of thyroid nodules and cervical lymph node using ultrasound-guided minimally invasive biopsy has high clinical consistency, especially for small nodules, which not only avoids unnecessary over-treatment but also reduces the misdiagnosis of thyroid cancer.