Aim: To determine the frequency of malignancy in solitary thyroid nodule. Methods: This study was carried out in the Outpatients and inpatient department of Surgery Ibn-eSiena Hospital, Multan from July 2013 to June 2014. A total of 124 patients were included in the study. Results: Majority of the patients i.e. 53(42.7%) were between 31-40 years, mean and SD was 33.45+6.32, 95 (76.6%) were female and 39(23.4%) were male. Malignancy in solitary thyroid nodule (on histopathology) shows 19(15.3%) were malignant and 105(84.7%) were benign. Stratification of malignant solitary thyroid nodule shows out of 19 malignant cases 6(31.9%) were between 13-20 years 2(10.5%) were between 21-30 years, 4(21.1%) between 31-40 years. Conclusion: It is concluded from the study that a remarkable proportion of solitary thyroid nodule (15.3%) was malignant, which emphasizes on the early diagnosis and adequate treatment.