Background. The aim of this research is to investigate the feasibility of percutaneous ultrasound-guided microwave ablation (MWA) for benign solid thyroid nodules. Methods. Ultrasound-guided percutaneous microwave ablation was performed for 90 benign solid thyroid nodules in 75 patients. The volume changes of the nodules were evaluated before and after microwave ablation, and the cosmetic grading and clinical symptoms were assessed as well. Results. The volume of all the 90 benign thyroid nodules obviously decreased after microwave ablation at 3-, 6-, 9-, and 12-month follow-ups (p<0.01), while that of the control group increased at the follow-up of 12 months (p<0.01). The volume reduction rate (VRR) at 3-, 6-, 9-, and 12-month follow-ups was 55.98%, 69.31%, 76.65%, and 84.67% in the MWA group, respectively. The cosmetic problems and clinical symptoms were also improved in the MWA group. All the patients are well tolerated to the procedure. Hoarseness occurred in 2 cases (2.7%) and Horner syndrome in 1 case (1.3%), and 1 patient (1.3%) developed slight burn on cervical skin. Conclusions. Ultrasound-guided percutaneous microwave ablation is a practical method for treating benign solid thyroid nodules, and the complications were acceptable. The trial is registered with clinicaltrials.gov with the registration number NCT03057925.