During a thyroid ultrasound, thyroid nodule calcifications can be observed. Thyroid nodule calcifications are categorized into microcalcifications, coarse calcifications, and rim calcifications. Microcalcifications are mostly psammoma bodies or amyloid deposits within medullary carcinoma, leading to secondary calcification and fibrosis, while the latter two types are generally caused by nutritional deficiencies. Microcalcifications often appear as punctate hyperechoic spots and are commonly seen in papillary thyroid carcinoma, though they can also be found in other benign and malignant conditions. Coarse calcifications are more frequently observed in benign nodules, particularly in nodular goiter, but they can also appear in some cases of papillary thyroid carcinoma. Rim calcifications refer to calcifications located at the edges of thyroid nodules and are commonly seen in nodular goiter, serving as a marker of benign nodules. However, they are also frequently observed in papillary carcinoma and anaplastic carcinoma. Therefore, to differentiate between benign and malignant thyroid nodule calcifications, a comprehensive evaluation that includes the patient's medical history, physical examination, and laboratory tests is necessary.