Thyroid cysts are generally benign lesions and are typically classified as below 3B level in thyroid ultrasound grading, which means they are categorized as class 1, 2, or even 3. The decision to perform surgery depends primarily on the size of the thyroid cyst. If the cyst is large enough to cause compressive symptoms, then surgical treatment is necessary at that time. Secondly, if the development of the thyroid cyst is rapid, and fine needle aspiration of the thyroid reveals malignant changes, then surgery is also required. For routine thyroid examinations, if the thyroid cyst is relatively small, classified at a lower level, and there are no associated thyroid functional abnormalities, regular follow-up is generally sufficient without the need for surgical intervention.