A "cold" nodule is a clump of thyroid cells that are inactive, inert. They are not, typically, producing thyroid hormone, growing, dividing, or undergoing other cell metabolic processes either. Conversely, a "hot" nodule, would be a clump of thyroid cells that is wildly over-active, producing lots of thyroid hormone. That, at least, is an amateur’s explanation. ; ) I have a family member who is at higher-than-normal risk for thyroid cancer due to radiation exposure as a baby, and when he turned up with cold nodules, we were told that they are rarely cancerous. He was biopsied anyway, to be on the safe side, due to his risk factors.