Abstract: Objective: To explore the clinical character of the papillary microcarcinoma (PMC) of the thyroid and speciality in its diagnosis and treatment. Methods : The clinical, pathologic and followup information of 20 cases of thyroid PMC which only appeared clinically as the neck nodular metastasis from 1991 to 2003 treated in our department surgically was collected and reviewed. Results : Fifteen cases of patients were diagnosed to be thyroid PMC by the biopsy of neck nodular preoperatively and 5 cases by frozen section pathological examination during the operation. All of these cases underwent neck dissection. Neck nodular metastasis was found in all of the cases and most of them occurred at level !. Conclusion : Thyroid PMC which occurs neck nodular metastasis obviously belongs to progressive carcinoma. It can be diagnosed by the biopsy of neck nodular preoperatively or by frozen section pathological examination during the operation. Neck dissection operation should be conducted actively and early.