Objective To explore the application value of routine ultrasound combined with ultrasound elastography in the differential diagnosis of thyroid tumors.Methods A retrospective analysis was performed on the 1499 patients with thyroid tumors undergoing examinations in ultrasound medicine department of Xingyang People's Hospital between April 2021 and April 2022. All underwent ultrasonography, including 68 cases with suspected malignant lesions who underwent ultrasound elastography and thyroid needle biopsy. The ultrasound characteristics of thyroid cancer and benign tumors were compared. The consistency between routine ultrasound, ultrasound elastography and pathological results was analyzed.Results There were significant differences in tumor aspect ratio, echo, border, morphology and calcification characteristics between patients with thyroid cancer and benign thyroid tumors (P<0.05). The sensitivity, specificity and accuracy rates of routine ultrasound combined with ultrasound elastography in the differential diagnosis of thyroid cancer and benign tumors were 95.65%, 80.00% and 85.29%, respectively.Conclusion Routine ultrasound combined with ultrasound elastography has good differential diagnosis value for thyroid tumors.