Thyroid nodules are common in the general population and most are benign. The decision to treat is individualized based on the nodule's ultrasonographic characteristics, functional status, cytological evaluation, and the patient's symptoms/cosmetic concerns. In recent years, ultrasound-guided ablation therapies, which offer a minimally invasive approach, have emerged as an alternative or complementary option to surgery due to their short recovery time, outpatient applicability, and preservation of healthy thyroid parenchyma in most cases. This section covers the steps for pre-ablation evaluation in thyroid nodules (risk classification, biopsy indications, voice assessment, and anticoagulant management), the biophysical principles of thermal ablation and the methods used in clinical practice (radiofrequency ablation, laser ablation, microwave ablation, and high-intensity focused ultrasound). Furthermore, the role of alcohol ablation, a chemical method, in cystic-predominant nodules is emphasized. Radiofrequency ablation, in particular, is explained in detail with standardized application principles such as the transisthmic approach under local anesthesia and the moving shot technique; appropriate patient selection, preservation of adjacent critical structures with hydrodissection, and early recognition of complications during the procedure are highlighted. Finally, post-ablation ultrasonographic evaluation, short- and long-term follow-up plans, efficacy criteria (volume reduction rate, symptom/cosmetic scores), and potential complications are summarized in light of current evidence.