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Among the genetic alterations identified in thyroid cancer, certain gene rearrangements, such as those involving NTRK and RET, have led to the development and clinical application of targeted therapies. However, the prevalence of these actionable gene rearrangements is relatively low, and applying next-generation sequencing (NGS) to all patients is limited by cost considerations. In this study, we aim to identify gene rearrangements in thyroid cancer using targeted next-generation sequencing and to characterize the associated pathologic features. By defining the clinicopathologic characteristics associated with gene rearrangements, we seek to develop a more cost-effective strategy to screen patients who are most likely to benefit from NGS testing.