The instability and rupture of nanoscale liquid threads is shown to strongly depend on thermal fluctuations. These fluctuations are naturally occurring within molecular dynamics (MD) simulations and can be incorporated via fluctuating hydrodynamics into a stochastic lubrication equation (SLE). A simple and robust numerical scheme is developed for the SLE that is validated against MD for both the initial (linear) instability and the nonlinear rupture process. Particular attention is paid to the rupture process and its statistics, where the "double-cone" profile reported by Moseler and Landmann [Science 289, 1165 (2000)] is observed, as well as other distinct profile forms depending on the flow conditions. Comparison to the Eggers' similarity solution [Phys. Rev. Lett. 89, 084502 (2002)], a power law of the minimum thread radius against time to rupture, shows agreement only at low surface tension; indicating that surface tension cannot generally be neglected when considering rupture dynamics.