The incidence of papillary thyroid carcinoma (PTC) is increasing recently. Although normally having lower malignancy and favorable prognosis, local recurrence of PTC is still correlated with malignant transformation. No clear preventive or managing strategy has been postulated against PTC so far, making the early diagnosis as critical important for improving life quality and extending life span. Current diagnostic approach for PTC mainly consists of color ultrasound combined with pathological examination after biopsy. This retrospective study collected both ultrasound and pathological examination results from patients with thyroid nodules in our hospital, in an attempt to investigate the diagnostic value of color Doppler ultrasound and elastography score. Diagnostic rates of elastography score for PTC and other thyroid cancers were 93.88% and 83.33%, respectively. The elastography score for benign nodules was significantly lower than that of malignant nodules, accompanied with remarkably higher ROI A value. The combined between gray scale/color Doppler ultrasound graph with elastography score shows a higher sensitivity (98.28%) and specificity (98.55%) with coincidence being 99.04%, suggesting a high diagnostic rate and accuracy for PTC. Area under curve (AUC) was 0.843, 0.864 and 0.904 for Ultrasound, Elastography score and Ultrasound+Elastography, respectively. Pathological examination after biopsy, however, is still required for results that cannot be deduced from ultrasound images. Color Doppler ultrasound can clearly reveal the granular calcification inside lesions, along with other features such as burrs on edge or hemodynamic indexes. In combined with elastography score, it can provide evidences for differential diagnosis of thyroid tumor, with significant clinical values. © 2017, E-Century Publishing Corporation. All rights reserved.