Thyroid nodules are common in the general population, and their incidence is higher in women and the elderly. It is estimated that 19–67% of randomly selected individuals harbor thyroid nodules when examined by high-resolution ultrasound. Thyroid cancer occurs in just 5–15% of thyroid nodules; risk factors include age, sex, radiation exposure, family history, and other factors. However, the incidence of newly diagnosed thyroid cancers in the United States has increased from 3.6 per 100,000 in 1973 to 8.7 per 100,000 in 2002. This is almost exclusively due to an increase in the detection of papillary thyroid carcinoma which increased 2.9-fold between 1988 and 2002. Of the latter, nearly 50% are subcentimeter nodules and 87% are cancers measuring 2 cm or less [4]. An increase in the use of neck ultrasound is likely responsible for this trend. In addition, a number of these small cancers are found incidentally on imaging studies of the neck (e.g., magnetic resonance imaging, full body scan, carotid Doppler, and PET CT scan) performed for unrelated reasons. The increased use of neck imaging studies is also responsible for the detection of nonpalpable thyroid nodules termed “incidentalomas,” which have the same risk of malignancy as palpable nodules of the same size. Fine-needle aspiration (FNA) remains the ultimate test, in conjunction with clinical judgment, to triage those individuals who will most benefit from surgery. This is substantiated by the fact that over 50% of surgically resected thyroid nodules are malignant, whereas prior to the routine use of thyroid FNA, only about 14% were malignant.