The detection rate and incidence of thyroid nodules have increased year by year. Ultrasound-guided fine needle aspiration cytology（FNA）is the gold standard for preoperative evaluation of the nature of thyroid nodules. However，approximately 20% to 30% of thyroid nodules by FNA are not clearly benign or malignant. Patients with such nodules are often received diagnostic surgery. Most nodules are confirmed benign lesions by postoperative pathological findings. Thus，those nodules have accepted unnecessary surgery. Preoperative accurate diagnoses like genetic tests are used to identify benign or malignant nodules to avoid overtreatment. This article reviews the genetic diagnosis advances and clinical value of risk assessment，efficacy prediction，and prognosis for thyroid nodules.