Abstract Background: Thyroid nodules are a frequent finding on necksonography. Ultrasound is the most commonly used imaging technique for the evaluation of thyroid nodules. Thyroid nodules are vastly prevalent whereas thyroid cancer is a relatively rare entity. Aim of Study: The aim of this study is to evaluate the risk stratification system used by the American College of Radi-ology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS). Patients and Methods: Across sectional study, the study setting was conducted at Ain Shams University Hospitals, from January 2020 till July 2020. This study was performed on random sample of 30 patients have thyroid nodules were included in this study. Results: In this study was found that 66.7% of the malig-nant nodules had smooth margins and 33.3% of the malignant nodules had lobulated or irregular nodules. Also, it was found that of the 31 benign nodules included in our study, 20 nodules (64.5%) had smooth margins and 11 nodules (35.5%) had ill defined margins; showing significant increase in benign group than malignant group. In this study, the results to were com-parable those reported in other studies, 11.1% of the malignant nodules had no echogenic foci, 11.1% of the malignant nodules had macrocalcifications, 11.1% of the malignant nodules had peripheral calcifications, 66.7% of the malignant nodules had punctate echogenic foci. Nodules with no echogenic foci had a statistically significant increase in benign group than malig-nant group. Conclusion: The ACR TI-RADS scoring system is a simple and practical method for assessing thyroid nodules and has shown an excellent diagnostic accuracy for the diag-nosis of malignant thyroid nodules in the present study.