Aim: To determine parenchymal thyroid diseases using Ultrasonography (USG) in adult patients. Methodology: This study was conducted in the department of Radio-diagnosis, Maharishi Markandeshwar University, Solan. It comprised of 75 adult patients age ranged 21-70 years of age. All patients were well informed regarding the study and their consent was obtained. Particulars such as name, age, gender was recorded in case history proforma. A thorough clinical examination was performed in all patients. Patients were divided into five groups such as group I (normal); group II had first detected, early untreated Hashimoto disease (EH); group III comprised of chronic Hashimoto patients that are under treatment and/or follow up (H); group IV had multinodular parenchymal hyperplasia (M)and group V had nodular hyperplasia with Hashimoto (HM). All examinations were performed with the patient in a supine position with the neck hyperextended. We calculated the thyroid volume with an automated formula (length £ width £ depth £ 0.52). We categorized the thyroid gland echogenicity as hypoechoic, isoechoic or hyperechoic relative to the cricoid cartilage. We evaluated the parenchyma for the presence of nodules, as well as the visibility of tiny echogenic reticulations.