The benign or malignant nature of a cold nodule in the thyroid can never be definitely assessed before surgery. All cold nodules that show no tendency to regress must be resected. The nodule is resected with surrounding healthy tissue and immediately examined in freezen sections. Out of 108 cases of simple resection of the nodule only one diagnosis of carcinoma was missed at the operation. That patient was reoperated two weeks later with curative intention.