In this paper, the joint imaging of ^99mTcO₄^‾ and ^99mTc-methoxy isobutyl isonitrile was compared with neck Color Doppler Ultrasonography (CDU) to identify its value in thyroid carcinoma, postoperative recurrence or cervical metastases. Thyroid carcinoma patients (150 operated and 21 re-operated with suspected postoperative recurrence or cervical metastases) were retrospectively analyzed. Taking the pathological result as the gold standard, the thyroid foci (437 cases), the thyroid foci of ≥1-cm diameter (215 cases) and the suspected postoperative recurrence or cervical metastases (87 cases) were compared by diagnostic results of the joint imaging and the neck CDU. The sensitivity, specificity and accuracy of the joint imaging were 64.18%, 80.00% and 67.82%, and 44.78%, 40.00% and 43.68%, respectively, for the cases with suspected postoperative recurrence or cervical metastases. For thyroid carcinoma of ≥1-cm diameter, the sensitivity of the joint imaging was 97.75%, and the neck CDU was 89.89%, but both specificity and accuracy was similar for thyroid carcinoma independence on their diameter. For thyroid carcinoma, the sensitivity of the joint imaging was 81.99%, and the neck CDU was 89.10%. The results show that the joint imaging is sensitive for large diameter thyroid carcinoma.