Aims and objectives: 1. To assess the efficacy of Strain Elastography in evaluation and differentiation of benign from malignant thyroid nodules. Material and methods: Study was performed in 100 patients referred with preferably solitary thyroid nodules, and in patients with multiple thyroid nodules, the largest and most accessible nodule was taken. All the patients underwent Sonography and Elastography and were correlated with FNAC / histopathology wherever possible. Results: Cut off value of ≥4 score for Elastoscan for diagnosis of malignant thyroid nodules had sensitivity, specificity, diagnostic accuracy, area under curve, PPV & NPV of 76.2%, 96.2% 92.0%, 0.851, 84.2% & 93.8% respectively for differentiating malignant from benign thyroid nodules. Cut-off value of ≥1.70 for E-strain had sensitivity, specificity, diagnostic accuracy, area under curve, PPV & NPV of 95.2%, 89.9%, 91.0%, 0.952, 71.4% & 98.6% respectively. Cut off values for Emean of ≥46.0 kPa had sensitivity, specificity, diagnostic accuracy, area under curve, PPV & NPV of 90.5%, 83.5%, 85%, 0.880, 59.3% & 97.0% respectively. Conclusions: Strain and shear wave elastography offer valuable additions to the diagnostic toolbox, particularly for solid and non-calcified nodules. These techniques demonstrate high reliability and accuracy in differentiating between malignant and benign nodules, making them a valuable complement to FNAC (fine-needle aspiration cytology).