Objective: To investigate the application value of Chinese thyroid imaging reporting and data system( C-TIRADS) in the prediction of benign or malignant thyroid nodule. Methods: A total of 123 thyroid nodules were retrospectively analyzed. Using ultrasound images, the thyroid nodules were classified according to three different classification criteria of C-TIRADS, ACR(American college of radiology) TI-RADS and Kwak TI-RADS to predict the risk of malignancy, compared with pathological as the gold standard. The differences in diagnostic efficacy between groups before and after combined elastography were compared. Results: The C-TIRADS classification of thyroid nodules was positively correlated with the malignant rate of nodules (P＜0.01). In independent prediction, the diagnostic efficiency of C-TIRADS was higher than that of ACR TI-RADS and Kwak TI-RADS, and the Area under the receiver operating characteristic curve (AUC) was 0.88, with the highest sensitivity (94%). Combined with elastography, C-TIRADS got the highest AUC (0.90), and the specificity was significantly increased (P＜0.05), the sensitivity was higher than that of ACR TI-RADS and Kwak TI-RADS (P＜0.05), and the diagnostic efficiency was significantly higher than before. Conclusion: C-TIRADS has a good clinical application prospect in the evaluation of thyroid nodules, and combined with elastography improves the specificity of clinical diagnosis.