Abstract: Objective To study clinicopathology of papillary thyroid microcarcinoma (PTMC) and how to dissect the central compartment lymph node during operation. Methods The clinicopathologic data of 125 cases with PTMC(in 2010) were reviewed and the diagnostic criterion of PTMC were analyzed. Pathological data of PTMC among recent 3 years were compared. Results In 125 patients of PTMC, 17 was males(13.6%),107 females(85.6%) and 1 unrecorded. 64 cases(51.2%) were more than 45ys and 58 cases(46.4%) were less than 45ys. The cancer locations were as follows: left side 49 cases(39.4%), right side 63 cases (50.4%), bilateral 12 cases(9.6%), and isthmus 1 cases. The frozen section during operation was performed in 121 cases. The right diagnosis was observed in 113 cases (accuracy rate 93.4%), and missed diagnosis in 8 cases (error rate 6.6%). Ninty-two cases had ipsilateral compartment lymph node dissection, of whom, 28 cases were found lymph node metastasis(30.4%). Among the PTMC cases, patients with the primary lesion ≥0.5 cm had slightly higher central node metastasis, compared with those with lesion ＜0.5 cm,34.0% (18/53) vs.25.6%(10/39), P=0.391. Conclusion A prophylactic dissection of central compartment lymph nodes should be performed to PTMC diagnosed by intraoperative frozen section.