In this review, we propose implementation of the five-category Thyroid Imaging Reporting and Data System (TIRADS) risk scoring system in Denmark, to obtain a structured and standardised thyroid ultrasound reporting, and for better selection of nodules recommended for biopsy and follow-up. This is based on recent European guidelines. A major goal of ultrasound assessment of thyroid nodules is to depict those lesions, which should undergo fine needle aspiration biopsy in order to diagnose thyroid malignancy. As no single sonographic criterion is sufficiently accurate in this respect, the clinician is left with little guidance regarding a cost-effective approach for the workup of thyroid nodules.