The value of intraoperative pathologic consultation (including frozen-section [FS]analysis) in surgical management of thyroid lesions has decreased since the advent of preoperative fine-needle aspiration. This study presents an intraoperative consultation experience with tumor scrape preparations stained with Ultrafast Papanicolaou stain and FS analysis in 93 cases of thyroid nodules and 4 lymph nodes (as part of lymph node dissection due to thyroid malignancy) in 87 patients at the University of Pisa, Pisa, Italy. FS was performed in 41 cases (48%). The scrape preparation diagnoses included 71 malignancies (69 papillary and 2 poorly differentiated carcinomas); 1 "suspicious for carcinoma"; 9 follicular neoplasms; 13 benign (9 "no tumor seen," 1 thyroiditis, 1 hyperplastic nodule, and 2 nodular goiters); and 3 nondiagnostic cases. The final diagnosis agreed with the scrape diagnosis in 95 cases (98%). FS agreed with the final diagnosis in 29 cases (71%). We suggest that intraoperative scrape preparations of thyroid nodules stained with the Ultrafast Papanicolaou method might be a useful adjunct in the intraoperative management of thyroid nodules.