A large proportion of patients with thyroid nodules in China undergo thyroidectomy in order to getconfirmatory histology diagnosis. The financial impact of this modality remains to be investigated. To evaluaterationality of performing thyroidectomy without a routine FNA preoperatively from the economic perspective,we conducted a retrospective, observational study of all archival thyroidectomies with records of cost per stay(CPS), cost per day (CPD) and length of stay (LOS) from 2008 to 2013 in the First Affiliated Hospital of NanjingMedical University. We compared all the parameters between cancer and non-cancer thyroidectomies. Werecruited 6, 140 thyroidectomies with valid records of CPS, CPD and LOS in this period. The CPS of cancerthyroidectomy was significantly higher than non-cancer thyroidectomy. The percentage of cancer thyroidectomyincreased from 26.5% to 41.6%. The percentage of annual cost of cancer thyroidectomies rose from 30.2% to45.2%. The LOS for cancer and non-cancer thyroidectomy decreased while the CPD increased in the past sixyears. The estimated national cost in 2012 for all thyroidectomies would be USD 1.86 billion with USD 1.09billion for non-cancer thyroidectomies. We have witnessed great improvement in the healthcare for patientswith thyroid nodules in China. However, given limited healthcare resources, currently thyroid FNA for moreprecise preoperative diagnosis may help to curb the rapidly increasing demand in healthcare costs in the futurefor nodular thyroid disease in China.