Abstract: Pediatric and adolescent thyroid cancer is a rare malignant tumor with etiology, clinical-pathological features, and prognosis differing from adult thyroid cancer, exhibiting an increasing incidence over the years. Compared to adults, children and adolescents are more sensitive to radiation, making it a definite risk factor for the development of thyroid cancer in this population. Radiation primarily originates from nuclear accidents and medical exposure. This review comprehensively explores the molecular changes induced by radiation leading to thyroid cancer in children and adolescents, aiming to raise awareness of the hazards posed by radiation to the thyroid health of this specific age group. The in-depth analysis provided in this medical review serves as a valuable reference for gaining insights into the disease mechanism and guiding future research endeavors.