HIFU has emerged as a promising non-invasive technique for the ablation of benign thyroid nodules. This chapter provides a comprehensive overview of HIFU thyroid ablation, focusing on the procedure itself, safety and efficacy, and limitations and future implications. In detailing the procedure, this chapter elucidates the key steps involved in HIFU thyroid ablation. It covers patient selection criteria, pre-procedural evaluation, and treatment planning. Additionally, it discusses the technical aspects of HIFU and monitoring techniques. This chapter also emphasizes the importance of real-time monitoring during the procedure to ensure accurate targeting and minimize the risk of complications. Safety and efficacy considerations are thoroughly addressed, emphasizing the growing body of clinical evidence supporting the use of HIFU for benign thyroid nodules. The chapter discusses studies evaluating the reduction in nodule volume and improvement in clinical symptoms. Safety profiles, including adverse events and long-term follow-up, are also discussed. However, limitations and challenges are acknowledged. In conclusion, this chapter provides a comprehensive and up-to-date overview of HIFU thyroid ablation for benign nodules. It emphasizes the potential of HIFU as a non-invasive alternative to surgery, highlighting its safety, efficacy, and patient satisfaction. The chapter acknowledges the limitations and challenges associated with HIFU, calling for continued research and collaboration to further refine this innovative modality and expand its clinical utility in the management of thyroid nodules.