Background: Thyroid nodules account for 10-15 % of thyroid cancers or malignancies and ultrasound (US) is the most accurate technique for evaluating thyroid nodules. Ultrasound-based datasets aid in detecting malignancy risk and avoiding Fine Needle Aspiration (FNA) biopsy. There are several guidelines for determining thyroid nodules, and ACR-TIRADS (American College of Radiology Thyroid Imaging Reporting and Data Systems) is the most accurate and widely used. However, very few or no studies have compared various grades of ACR-TIRADS based on benign and malignant nodules. Therefore, this study aimed to investigate the predictive risk of malignant cancer in thyroid nodules obtained from an ultrasound dataset based on the ACRTIRADS classification. Materials and Methods: PubMed, Medline, EMBASE (Excerpta Medica dataBASE), Google Scholar, Cochrane Library, and Web of Science were searched for articles published between Jan 2018 to 30 June, 2022, and ultrasound based datasets were obtained for benign and malignant thyroid nodules based on ACR-TIRADS. Results: Ten articles were included with 12723 total cases of thyroid ultrasound dataset for benign and malignant thyroid nodule classification. The total number of benign was 6641 and the total number of malignant thyroid nodules was 6082 respectively (95 % CI=1.14, 0.75-1.74) with P=0.53. The number of TR4 and TR5 malignancies were 1397 and 3733 respectively (95 % CI=0.42, 0.22-0.83) with P=0.01. Conclusion: The TR4 and TR5 grading of the ACR-TIRADS represents an excellent stratification system for classifying thyroid lesions thereby avoiding biopsies performed on benign nodules.