Abstract: Objective To study the clinical diagnostic value of ultrasound-guided coarse needle（18G） biopsy（US-CNB） for diagnosis of thyroid nodule lesions. Methods One hundred and fifty patients（157 thyroid nodules） who underwent US-CNB and surgery in Chinese PLA General Hospital from October 2010 to May 2011 were included in this study.The findings in US-CNB and surgery were compared.The US-CNB demonstrated that thyroid nodule lesions could be classified as benign,malignant or uncertain. Results Of the 157 thyroid nodule lesions,139 and 18 were diagnosed as malignant and benign respectively,while 131（81.45%）,17（10.83%）and 9（5.73%） were diagnosed as malignant,benign and uncertain respectively by US-CNB,with a sensitivity of 96.27%,a specificity of 85.71% and an accuracy of 95.27%.Bleeding occurred in 1 patient（0.63%） after puncture.The diagnosis rate was increased when the thyroid nodule sample with its maximum diameter ≥0.4cm was used. Conclusion US-CNB is a safe and simple procedure for the puncture of thyroid nodule lesions when surgical sampling is impossible.