Objective To evaluate our experience in the diagnosis and surgical management of papillary thyroid microcarcinoma(PTMC). Methods Clinical data of 42 PTMC cases were retrospectively analyzed. Results Twenty-five clinically nonpalpable PTMC were detected by high resohition thyroid uhrasonography preoperatively.The diagnosis of PTMC was established intraoperatively by frozen biopsy in 14 out of 19 cases undergoing this procedure.Of the 42 patients,30 underwent a lobectomy,and in 11 out of 30 patients supplemented level Ⅵ lymph node dissection was performed.None of these patients had recurrence during follow-up.The recurrence in three patients with multffocal lesions and undergoing incomplete resection were observed at follow.up.The mulifocality of PTMC and ipsilateral residual volume of the thyroid were two predicting factors that significantly influence the postoperative recurrence(P＜0.05,P＜0.01 respectively)in patients with PTMC. Candus-ions PTMC is usually occult and eludes correct preoperative diagnosis.Most PTMC are clinically nonpalpable and may be detected by hish resolution thyroid ultrasonography and diagnosed by frozen section during the operation.Surgery is the most important treatment of PTMC.Lobectomy plus level Ⅵ lymph node dissection is the therapy of choice for PTMC patients at the stage of cN0.