Abstract Background: Nodules of thyroid gland are very common and the majority of them are benign. Sonography has many favorable features, such as detection of non-palpable nodules, estimation of size and volume of the nodule and guidance for Fine Needle Biopsy (FNB). High-resolution ultrasound is very sensitive in detection of thyroid nodules, enabling dif-ferentiation of solid and fluid-containing lesions. Indeterminate and non diagnostic patterns represent the main limitation of Fine Needle Aspiration (FNA) cytology of thyroid nodules, clinical and echographic features can poorly predictive of malignancy. The newly developed real-time Ultrasound Elas-tography (USE) has been applied to differentiate malignant from benign lesions. Aim of Study: To evaluate indeterminate thyroid nodules by US elastography and colour Doppler study. Material and Methods: In this study, 73 cases were in-cluded from which 57 cases were benign and 16 cases were malignant. The cases were subjected to complete U/S, Doppler examination, Micro pure imaging and US elastography the results were compared to U/S guided FNAC. Results: The most predictive combined ultrasound features are disappearing halo sign with the appearance of dots of micro calcifications and by colour Doppler ultrasound marked intra nodular and absent or slight peri nodular blood flow represented with malignant nodules more than benign, the combination of US elastography with US findings clears that hypoechogenicity/score 4-5 was the most predictive of malig-nancy with sensitivity 80% and specificity 100%; and accuracy 93.4%. Conclusion: US-elastography combined with colour Dop-pler US, has rapid and easy performance and can help to identify nodules of thyroid gland that are likely seems to be malignant.