Abstract : <p><strong>Background: </strong>Thyroid nodules are common, and there is an increasing awareness about Thyroid-stimulating hormoneas a cancer risk. The current meta-analysis aimed to assess the link of TSH to thyroid malignancy among patients with thyroid nodules.</p> <p><strong>Subjects and Methods:</strong> We searched PubMed, EBSCO, Cochrane Library, and the first 100 articles in Google Scholar from the first published article up to April 2022; we included prospective cohorts, retrospective studies, and case-control studies. Case series and case reports were not included. The following terms were used: thyrotropin-releasing hormone, TSH, thyroid nodule, malignant potential. The Revman system was used for data analysis.</p> <p><strong>Results:</strong> In the present meta-analysis, (9 studies and 4565 patients were included, the studies were six retrospective, two prospective, and one cross-sectional). More than half of the studies were from Asia, two from Europe, one from the USA, and one from South America. The TSH level was associated with thyroid nodule malignant potential (odd ratio, 0.78, 95% CI, 0.27-1.30, P-value, 0.003). However, the heterogeneity was substantial, I2, 83%, P-value, &lt;0.001, and Chi-square, 24.05.</p> <p><strong>Conclusion:</strong> Higher TSH levels were associated with increasing malignancy among patients with thyroid nodules. Serum TSH level might be included among risk factors of malignancy in patients with thyroid nodules. Larger prospective studies with longer duration are needed. &nbsp;&nbsp;</p>