In this retrospective cross-sectional study we aimed to investigate of the impact of frozen section analysis (FSA) on the surgical strategy in nodular thyroid diseases. The patients who underwent thyroidectomy (n=293) were analyzed retrospectively and 138 of 293 who had intraoperative FSA results included to the study. All these patients (n=138) also had fine needle aspiration biopsy (FNAB). The patients (n=138) were divided to 5 groups; Group 1 (n=32), Group 2 (n=22), Group 3 (n=12), Group 4 (n=17) and Group 5 (n=55). Twelve of these patients who were reported as “follicular neoplasia” in FSA were excluded from the study. According to the results of FSA (n=126), 48 patients were reported as malignant, whereas 78 patients were benign. The permanent sectional pathological examination (n=126), 57 patients were reported as malignant and 69 were benign. The sensitivity of FSA was found 78.9% and the specificity was found 95.6%, respectively. Also, FSA affected the surgical strategy correctly in 111 (88.1%) and incorrectly in 15 patients (11.9%). As a conclusion of this study we found that frozen section analysis significantly affects the surgical strategy especially in patients whose surgical strategy cannot be determined by FNAB.