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Objective To explore the application value of Thyroid Imaging Reporting and Data System (TI-RADS) stratification in diagnosing thyroid nodules in respect of the effect of age and gender. Methods A total of 684 patients with thyroid nodules, including 118 males and 566 females, were stratified into subgroups according to their age and gender, and the results of TI-RADS evaluation were compared with their pathological diagnosis. Results The sensitivity, specificity, and AUC of TI-RADS grading for malignant thyroid nodules in the males was 84.7%, 66.7%, and 0.803 (95% CI 0.709-0.897), respectively. In the females, the sensitivity and specificity were 80.8% and 65.0%, respectively, with an AUC of 0.812 (95% CI 0.758-0.849). There was no statistically significant difference between genders when using TI-RADS to determine the nature of thyroid nodules (P>0.05). In the patients aged 26-35 years, the sensitivity, specificity and AUC of TI-RADS classification for malignant thyroid nodules were 85.4%, 90.0%, and 0.915 (95% CI 0.818-0.987), respectively. In the patients aged 36-45 years, the sensitivity and specificity of TI-RADS classification for malignant thyroid nodules were 84.4% and 78.1%, respectively, with an AUC of 0.898 (95% CI 0.842-0.953). In the patients aged 46-55 years, the corresponding parameters were 79.7%, 71.4% and AUC 0.822 (95% CI 0.789-0.925), respectivey, while in those aged 56-65 years, the corresponding data were 75.6%, 60.0%, and AUC 0.729 (95% CI 0.576-0.785), respectively. The ROC curve of patients aged 56-65 years was statistically significantly different from those of patients aged 26-35, 36-45 and 46-55 years (P<0.05 for all). Conclusions Patient gender has no significant effect on the results of TI-RADS classification, but age of the patients does. The age factor should be considered during ultrasound diagnosis of thyroid nodules using TI-RADS classification. [ABSTRACT FROM AUTHOR]