One hundred and seventeen patients with various thyroid diseases were examined with colour-coded duplex ultrasonography permitting simultaneous real-time display of soft tissue and blood flow. Twenty-four out of 25 patients with an autonomous adenoma, all six patients with thyroid carcinoma and five out of 61 patients with simple nodular goitre showed increased vascularity. Absence of increased vascularity would seem an important parameter for the exclusion of autonomous adenoma and thyroid carcinoma in patients with nodular goitre.