ObjectiveTo summarize the recent advances and clinical applications of molecular testing in thyroid cancer, discussing its significance in the era of precision medicine and future perspectives. MethodsA systematic review of relevant domestic and international literature was conducted to identify key molecular events closely associated with the development, progression, and prognosis of thyroid cancer, and to evaluate their clinical utility. ResultsMolecular testing provides critical auxiliary diagnostic information for thyroid nodules with indeterminate fine-needle aspiration results. Furthermore, for diagnosed differentiated thyroid cancer, molecular markers serve as important tools for precise risk stratification, guiding surgical extent, radioactive iodine therapy decisions, and targeted drug applications. ConclusionMolecular testing has become a cornerstone tool in advancing thyroid cancer management toward precision medicine, future efforts should focus on exploring novel molecular markers and optimizing clinical practice guidelines.