Objective to explore the imaging characteristics and display location of normal parathyroid gland in high frequency ultrasound, color and energy doppler ultrasound, ultrasound elasticity examination, and contrast-enhanced ultrasound, so as to provide guidance for the protection of normal parathyroid gland in clinical thyroidectomy. Methods select 220 cases of normal adults and 60 cases of merger to total excision of the thyroid gland, thyroid gland tumor all parathyroid ultrasonographic examination, location markers on the basis of the thyroid gland, line of high frequency ultrasound and color doppler ultrasound examination, energy and 50 cases of normal adult line ultrasonic elasticity to check at the same time, 20 cases of normal adult the contrast-enhanced ultrasound examination at the same time, the analysis summary of normal parathyroid ultrasonic image characteristics and location. The 60 cases of total thyroidectomy were divided into 30 cases of intraoperative ultrasonic examination and 30 cases of non-ultrasonic examination to compare the incidence of postoperative parathyroid dysfunction. Results ①there were 217 cases of parathyroid gland in 280 cases, and the high frequency ultrasound display rate was 77.5% (217/280). A total of 412 parathyroid glands were found, 36 (8.7%) located behind the upper thyroid pole, 138 (33.5%) behind the body, 179 (43.5%) behind the lower thyroid pole, and 59 (14.3%) within 2 cm below the lateral lobe. ②color and energy doppler ultrasound can display 301 blood flow signals (73.0%). ③the elastic value of 50 normal parathyroid glands measured by ultrasonography was (12.3±2.1) kPa, and the elastic value of adjacent normal thyroid gland was (27.2±2.5) kPa, the difference was statistically significant (P<0.05). ④contrast-enhanced ultrasonography of 20 normal parathyroid glands showed that the duration of contrast agent perfusion was about (4.8±2.4) s, with overall uniform enhancement and clear contour, and equal enhancement compared with adjacent normal thyroid parenchyma. ⑤there were 6 cases of low parathyroid function in patients without ultrasonic examination during the operation, and only 2 cases of patients with ultrasonic examination during the operation, the difference was statistically significant (P < 0.05). Conclusion the normal parathyroid ultrasonography usually presents elliptic hyperechoic and slightly hyperechoic nodules, which are mostly located near the lower pole of the thyroid gland, and can detect blood flow signals in the thyroid gland. The use of ultrasound in total thyroidectomy can reduce the incidence of postoperative parathyroid dysfunction.