Abstract: Objective To evaluate the regularity of papillary thyroid microcarcinoma lymph node metastasis and rational surgical methods. Methods The clinical and pathological data of 130 cases of thyroid papillary microcarcinoma were retrospectively reviewed. Results Totally 130 cases were all confirmed by pathology, including 108 cases of unilateral lesions, 22 cases of bilateral lesions. 37 cases (28.5%) had central lymph node metastasis, 17 cases ( 13.1 ) % occurred lateral of neck lymphatic metastasis. Conclusions Papillary thyroid microcarcinoma is often multifocal, so the initial surgery should be thyroidectomy or subtotal resection and central lymph node dissection should be done, Wheather to perform the lateral neck lymph node dissection or not should be based on preoperative ultrasound and other imaging data and inrtaoperativcly exploration.