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Most experts and scientific societies (EFSUMB, WFUMB, etc.) encourage the use of multiparametric ultrasound evaluation (MPUS) to improve thyroid nodule characterization due to the continuous technological developments including new ultrasound software (microvascular flow imaging, elastosonography, etc.), contrast media (CEUS), and artificial intelligence (AI). Therefore, the recognition and proper use of new multiparametric ultrasound features of thyroid nodules are essential for minimizing unnecessary interventions and guiding appropriate treatment. The goal of these guidelines is to help initiate use of these features in routine clinical practice. In addition, we analyze the use of MPUS in some emblematic thyroid scenarios, such as cytologically indeterminate nodules, multinodular goiters, and extrathyroidal extension of the malignant nodule, and the usefulness of MPUS as a guide for thyroid biopsy\/aspiration and in the staging of cervical lymph nodes. Recommendations based on the level of evidence of the published literature and on the EFSUMB expert group\u2019s consensus are given for each question.<\/jats:p>","DOI":"10.1055\/a-2761-1191","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:36:42Z","timestamp":1764722202000},"page":"253-262","source":"Crossref","is-referenced-by-count":3,"title":["EFSUMB Guidelines on Multiparametric Ultrasound Thyroid Nodule Evaluation: PART I"],"prefix":"10.1055","volume":"47","author":[{"given":"Vito","family":"Cantisani","sequence":"additional","affiliation":[{"name":"\u201cSapienza\u201d University of Rome, Italy","place":["Rome"],"department":["Department of BeSSA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9518-4855","authenticated-orcid":false,"given":"Maija","family":"Radzina","sequence":"additional","affiliation":[{"name":"Riga Stradins University, Latvia","place":["Riga"],"department":["Radiology 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