Abstract：Objective To investigate the efficacy of Shugan Xiaoying Decoction combined with Western medicine in the treatment of thyroid nodules. Methods A total of 98 patients with thyroid nodules treated in our hospital from January 2021 to January 2023 were randomly divided into an observation group and a control group, with 49 cases in each group. The clinical efficacy, levels of serum markers, and incidence of adverse reactions were compared between the two groups. Results The treatment efficacy in the observation group was higher than in the control group. The incidence of adverse reactions was lower in the observation group. Post-treatment levels of serum thymidine kinase 1 （TK1）, thyroglobulin, and thyroglobulin antibody in the observation group were lower than in the control group, while thyroid-stimulating hormone （TSH） levels were higher, with statistically significant differences between the groups （χ2＝6.078，4.405，t＝5.824、2.027、4.120、2.001，all P＜0.05）.   Conclusion The use of Shugan Xiaoying Decoction combined with Western medicine in treating thyroid nodules can enhance treatment efficacy, effectively improve serum marker levels, and is associated with good safety, making it worthy of clinical application and promotion.