| Objective: To explore the distribution of TCM syndromes of Hashimoto''s thyroiditis and its correlation with the ultrasonic manifestations of thyroid, such as size, echo, blood flow signals and other factors.Methods: In this study, 285 cases of Hashimoto thyroiditis were collected, and the basic clinical data were objectively recorded. The syndrome differentiation and typing were carried out according to the symptoms and signs. The size of thyroid gland, echo and blood flow were recorded by color Doppler ultrasonography. SPSS22.0 software was used for statistical analysis, and the relevant conclusions were drawn.Results: Among the 285 cases of Hashimoto thyroiditis studied, according to the classification of traditional Chinese medicine syndrome, the most patients were at least in order of liver Qi and stagnation, blood stasis and phlegm condensation, Qi and Yin deficiency, and spleen and kidney Yang deficiency.Thyroid size, Echo, and blood flow were significantly correlated with TCM syndrome type(P<0.01) Thyroid ultrasonography in patients with hepatic Qi depression was of normal size, the echo was uneven, and the blood flow was normal(Grade 0); Thyroid ultrasonography in patients with Qi and Yin deficiency was characterized by large volume, small flaky low echo areas or rope-like strong echoes, and rich blood flow(Grade I). Thyroid ultrasonography in patients with blood stasis and phlegm coagulation showed a large volume, a rosette strong Echo, which could be accompanied by nodules and abundant blood flow(Grade I and II). Thyroid ultrasonography in patients with spleen and kidney deficiency showed large volume, multiple nodular echoes, with grid changes, and blood flow was more normal(Grade 0 and I). Conclusion: Hashimoto''s thyroiditis has a certain correlation and regularity between thyroid size, Echo, and blood flow signals under ultrasound and various TCM types. It can be seen that thyroid ultrasound can assist the diagnosis of Chinese medicine syndrome differentiation of Hashimoto thyroiditis and provide a relatively objective theoretical basis for the microscopic differentiation of Chinese medicine.