Objective To analyze the efficacy and safety of ultrasound-guided radiofrequency ablation of thyroid nodules for benign thyroid nodules. Methods 82 patients with benign thyroid nodules admitted to our hospital from January 2022 to June 2024 were selected as the study objects. Patients were divided into control group and observation group by random number table method, with 41 cases in each group. The control group was treated with routine thyroidectomy. The observation group was treated with ultrasound guided radiofrequency ablation of thyroid nodules. The surgical effect, surgical complications, surgical related indexes (operation time, surgical incision length, blood loss) and thyroid hormone [thyroid stimulating hormone (TSH), Free triiodothyronine (FT3), Free Thyroxine (FT4)] levels were analyzed and compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05). The total complication rate of the observation group was significantly lower than that of the control group (P < 0.05). Operation time, incision length and blood loss in observation group were significantly lower than those in control group (P < 0.05). One month after surgery, the thyroid hormone indexes of TSH, FT3 and FT4 in both groups were significantly improved compared with those before surgery, and the thyroid hormone indexes of TSH, FT3 and FT4 in the observation group were significantly better than those in the control group one month after surgery (P < 0.05). Conclusion Ultrasound-guided radiofrequency ablation of thyroid nodules can improve the therapeutic effect, reduce complications, reduce operation time and incision length, reduce blood loss, and promote the recovery of thyroid function.