The 38th European Congress of Cytology 2014, held in Geneva, Switzerland, offered a specific symposium concerning the Bethesda thyroid classification scheme. What emerged in that thyroid symposium, which was attended by all of the authors of this commentary, was the persistent need for a universally adopted thyroid fine-needle aspiration reporting system that can diagnose the same thyroid nodule in the same way anywhere in the world. Herein, the authors critically outline the advantages and limits of thyroid fine-needle aspiration classification schemes that were discussed at the symposium.