Abstract: Objective In order to learn about the thyroid nodule detection rate and epidemiological characteristics of middle school students in hangzhou, and to analyze the relevant factors. Methods In October 2018, high-frequency ultrasound was used to perform thyroid ultrasound examinations on 596 middle school students in a middle school in Hangzhou. The internal echoes of thyroid nodules were analyzed, and univariate and multivariate linear regression analyses were performed between thyroid nodules and factors like age, sex, BMI or Tvol. Results In 596 middle school students, 369 were detected to have Thyroid nodules, the overall detection rate was 61.9%(369/596). There were 363 cases of cystic nodules and 5 cases of hypoechoic nodules. Among them, 201 cases were females with a detection rate of 69.1%(201/291) and 168 were males with a detection rate of 55.1%(168/305). The female thyroid nodule detection rate was higher than that of males, and the difference was statistically significant(χ²=12.360,P<0.001). The thyroid nodule detection rate did not increase with the increase of age(χ <mathml id="6"> <mrow><msubsup><mrow /><mrow><mtext>t</mtext><mtext>r</mtext><mtext>e</mtext><mtext>n</mtext><mtext>d</mtext></mrow><mn>2</mn></msubsup></mrow></math>" role="presentation" style="position: relative;"> <nobr aria-hidden="true"> 2trend </nobr> <math xmlns="http://www.w3.org/1998/Math/MathML"> <mrow> <msubsup> <mrow></mrow> <mrow> <mtext> t </mtext> <mtext> r </mtext> <mtext> e </mtext> <mtext> n </mtext> <mtext> d </mtext> </mrow> <mn> 2 </mn> </msubsup> </mrow> </math> <script type="math/mml" id="MathJax-Element-3"><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msubsup><mrow></mrow><mrow><mtext>t</mtext><mtext>r</mtext><mtext>e</mtext><mtext>n</mtext><mtext>d</mtext></mrow><mn>2</mn></msubsup></mrow></math></script> </mathml>=2.738, P=0.098) as well as the increase of BMI(χ <mathml id="7"> <mrow><msubsup><mrow /><mrow><mtext>t</mtext><mtext>r</mtext><mtext>e</mtext><mtext>n</mtext><mtext>d</mtext></mrow><mn>2</mn></msubsup></mrow></math>" role="presentation" style="position: relative;"> <nobr aria-hidden="true"> 2trend </nobr> <math xmlns="http://www.w3.org/1998/Math/MathML"> <mrow> <msubsup> <mrow></mrow> <mrow> <mtext> t </mtext> <mtext> r </mtext> <mtext> e </mtext> <mtext> n </mtext> <mtext> d </mtext> </mrow> <mn> 2 </mn> </msubsup> </mrow> </math> <script type="math/mml" id="MathJax-Element-4"><math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><msubsup><mrow></mrow><mrow><mtext>t</mtext><mtext>r</mtext><mtext>e</mtext><mtext>n</mtext><mtext>d</mtext></mrow><mn>2</mn></msubsup></mrow></math></script> </mathml>=1.152, P=0.131). There was a significant difference in the detection rate of unilateral and bilateral thyroid nodules between different genders(χ²=7.866, P=0.005). There was no statistical difference in the detection rate of single and multiple thyroid nodules between different genders(χ²=2.136,P=0.144). Conclusion The detection rate of thyroid nodules in a middle school student in Hangzhou is 61.9%, with a high detection rate, mainly bilateral, multiple, cystic nodules ≤ 0.5 cm.