Elastography technologies provide a new dimension in the evaluation of thyroid nodules. B-mode ultrasound imaging creates visualization of thyroid nodules but has a low sensitivity for predicting malignancy. Strain and shear wave elastography are next-generation technologies in evaluating thyroid nodules. They investigate differences in the mechanical properties of structures by applying an external force and monitoring the deformation response. Recent studies have demonstrated that strain and shear wave elastography stratify the malignancy risk for thyroid nodules as a single variable and in conjunction with other B-mode ultrasound features. Elastography can be added to B-mode ultrasound examinations of thyroid nodules. These technologies may improve our ability to detect thyroid cancer and lead to fewer unnecessary fine needle aspiration biopsies and thyroid surgeries. However, more prospective studies are required to determine the precise value of these new technologies in specific thyroid nodule subgroups.