Objective: To explore the diagnostic value of color Doppler ultrasound thyroid imaging report and data system (TI-RADS) combined with ultrasound elasticity in the diagnosis of thyroid cancer. Methods: A retrospective analysis was conducted on 102 patients with thyroid cancer admitted to Ningguo People’s Hospital from March 2018 to April 2021. The results of fine needle biopsy or surgical pathology were used as the “gold standard” to compare the TI-RADS grading and shear wave elastography (SWE) and the combined diagnosis of benign and malignant thyroid nodules. The receiver operating characteristic (ROC) curve of the subjects was further analyzed. Results: The surgical pathology results showed that there were 186 thyroid nodules in 102 patients, including 115 malignant nodules and 71 benign nodules. There were significant differences in TI-RADS grade and SWE parameter Ratio between malignant group and benign group (P<0.05). The area under the ROC curve (AUC) of TI-RADS, SWE and combined diagnosis of benign and malignant thyroid nodules were 0.794, 0.887 and 0.919, respectively. The value of combined diagnosis of benign and malignant thyroid nodules was higher than that of SWE and TI-RADS (P<0.05), and the value of SWE was higher than that of TI-RADS (P<0.05). Conclusion: Color Doppler ultrasound TI-RADS classification combined with SWE may have higher diagnostic value for thyroid cancer.