Objective To discuss the clinical value of strain ratio(SR)of ultrasound elastography(UE) combined with Micropure Imaging in differential diagnosis of benign and malignant thyroid nodules. Methods 48 patients with 64 thyroid nodules were enrolled in our hospital from February 2015 to June 2016. All patients were underwent traditional ultrasonography, UE and micropure imaging before operation, and compared with the results of pathological examination. Results Of 64 thyroid nodules, 35 lesions were benign, and 29 lesions were malignant. The detection rate of calcification in malignant nodules was 75.86% with micropure imaging, was higher than that (62.07%)of traditional ultrasonograph, which with significant different(p<0.05). SR of malignant nodules was higher than benign nodules(p <0.01), and when SR≧2. 92, the sensitivity and specificity for thyroid malignant lesions diagnosis were 79.3% and 71.4%, respectively. SR combined with micropure imaging had a higher sensitivity and specificity for malignant lesions diagnosis than that of SR technology, and highly correlated with pathological findings. Conclusion Strain ratio of ultrasound elastography combined with micropure imaging was an useful technolgoy in differential diagnosis of benign and malignant thyroid nodules.