Objectives: In children, the frequency of malignancy in thyroid nodules is higher than in adults. The aim of our study was to determine the effective factors in assigning malignant nodules in children with thyroid nodule. Materials and Methods: This is a retrospective, single-center study. Age, gender, laboratory, radiological, cytopathological and pathological data of 92 patients who were <19 years old and who underwent fine needle aspiration biopsy (FNAB) were recorded. Patients with benign and nonbenign (Bethesda 3-6) cytopathologies, and also patients with malign and benign pathologies were compared in terms of age, gender, laboratory and radiological findings. Results: FNAB cytopathologies were reported as 14.1% (13/92) non-diagnostic, 67.4% (62/92) benign, 7.6% (7/92) atypia or follicular lesion of undetermined significance, 7.6% (7/92) follicular neoplasia or its suspicion, 2.2% (2/92) suspected malignancy, and 1.1% (1/92) malignant. Neutrophil/lymphocyte ratio (NLR) and the frequency of solid nodules were higher in patients with non-benign cytology (p=0.042, p=0.014, respectively). Pathological examinations (n=21) revealed five carcinomas, two neoplasias with undetermined malignant potential, and 14 benign conditions. The frequency of overall malignancy was 5.4%. The mean age at diagnosis was lower; NLR and the frequency of solid nodules were higher in those with malignant pathology (p=0.042; p=0.016; p=0.026, respectively). The sensitivity of FNAB in detecting malignant nodule was 100%, specificity was 53.8%, and its diagnostic value was 66.7%. Conclusion: High NLR and solid nodule may indicate non-benign results in FNAB and malignant histopathology. The risk of malignancy may be higher in cases of younger age at diagnosis. FNAB has high sensitivity in detecting malignant nodules in children; however, studies are needed to increase specificity.