This study aims to explore the diagnostic value of the acoustic radiation force impulse (ARFI) technique for solid thyroid nodules with different diameters.A total of 212 solid thyroid nodules with pathological results in 191 patients from March to December 2017 were retrospectively reviewed. These nodules were divided into two groups according to their diameter: 117 nodules were ≥1.0 cm and 95 were <1.0 cm. Before the operation, the nodules were evaluated using conventional ultrasound and different ARFI technique, including virtual touch tissue imaging (VTI), virtual touch tissue quantification (VTQ), and virtual touch tissue imaging and quantification (VTIQ). Further, receiver operating characteristic (ROC) curves were drawn to analyze the diagnostic value of the ARFI technique for solid thyroid nodules with different diameters.For the three methods used in the diagnosis of solid thyroid cancer, VTI, VTQ, and VTIQ, the sensitivity, specificity, accuracy, and area under the ROC curve were 91.03%, 76.92%, 86.32%, and 0.840; 73.08%, 100%, 82.05%, and 0.865; and 91.03%, 100%, 94.02% and 0.955, respectively for nodules with a diameter ≥1.0 cm, and 84.62%, 70.00%, 80.00%, and 0.773; 61.54%, 80.00%, 67.37%, and 0.708; 75.38%, 90.00%, 80.00%, and 0.827, respectively for nodules with a diameter <1.0 cm.For nodules with a diameter ≥1.0 cm, the diagnostic efficacy of VTIQ is higher than VTI and VTQ. For nodules with a diameter <1.0 cm, the diagnostic efficacy of VTI and VTIQ are higher than VTQ.Copyright © 2022 Asian Surgical Association and Taiwan Robotic Surgery Association. Published by Elsevier Taiwan LLC. All rights reserved.