Objective To explore the accuracy of ultrasound in thyroid cancer screening and the reasonable operation of thyroid carcinoma. Methods Clinical data of 158 cases of thyroid carcinoma in recent three years were analyzed ret-rospectively in Yidu Central Hospital. Results The accuracy of ultrasound examination for thyroid carcinoma was more than 90%,even 98.3% combined with ultrasound contrast. Individual surgical approaches were used in this group. Half gland and isthmic portion and majority opposite side excision plus central lymph node dissection had been performed in 131 cases of patients with thyroid microcarcinoma,and lymph node metastasis rate was 19.8%(26/131). Conclusion Ultrasound and ultrasound contrast can significantly improve the detection rate of thyroid carcinoma and with high ac-curacy. It is also useful to make some judgments lymph node metastasis. Central lymph node dissection should be per-formed combining with gland excision in thyroid microcarcinoma.