Objective To investigate the outcomes and prognostic factors of differentiated thyroid cancer (DTC) with bone metastasis. Methods A retrospective study was conducted on 108 DTC patients with bone metastasis who were treated in the Cancer Hospital of Chinese Academy of Medical Sciences. Kaplan-Meier survival curves were generated. Log-rank test and Cox proportional hazards model were used to screen the prognostic factors. The correlation between treatment and prognosis was analyzed. Results The median overall survival was 70 months. The 5-, 10-, 15-, and 20-year overall survival rates were 54.4%, 24.3%, 9.8%, and 4.3%, respectively. Univariate analysis showed improved prognosis in patients with single bone metastasis, without skeletal-relatedevents (SREs), and without cervical lymph node metastasis (P = 0.003-0.019). Patients who received combined treatments (P < 0.001) or ¹³¹I treatment alone (P = 0.109) showed better prognosis than those without ¹³¹I treatment. Multivariate analysis identified single bone metastases, SREs, and treatmentas independent prognostic factors. Conclusion In DTC patients with bone metastasis, good prognosis is significantly associated with single bone metastases, absence of SREs, and ¹³¹I therapy in combination with other therapeutic approaches.