The thyroid gland is an endocrine organ sensitive to ionizing radiation. Long term exposure to low dose radiation (LDR) among radiation workers in work may lead to thyroid dysfunction or the formation of thyroid nodules. The influencing factors of these outcomes are various and multifaceted, including but not limited to environmental factors (iodine intake levels), occupational factors (length of service, personal dose), and individual factors (gender, age, smoking, alcohol consumption, obesity, blood pressure, blood glucose). Currently, there is no consensus on the specific trends of thyroid nodule development and thyroid function indicators in radiation workers caused by long-term LDR exposure. Therefore, molecular epidemiological investigations should be conducted to explore its pathogenesis in the future, and long-term epidemiological investigations with multiple centers and large samples can be conducted to further verify existing findings. Furthermore, strengthening occupational health training of radiation workers and standardizing personal dose measurement are beneficial for comprehensive prevention of thyroid diseases, and ensuring occupational health of radiation workers.