Abstract: Objective To investigate the relationship of tumor location, size, infiltration of thyroid capsule and other clinicopathological features with differentiated thyroid cancer with lymph node metastasis. Methods We retrospectively analyzed clinicopathological data of 248 patients treated with initial surgery in Head and Neck Surgery Department, Sichuan Cancer Hospital from July 2010 to July 2013. Results Tumor location, maximum diameter, quantity, infiltration beyond the outer membrane gland, involved number and other clinicopathologic features were related to level Ⅵ and Ⅱ-Ⅴ lymph node status; Younger age was only related to Ⅵ lymph node metastasis. When the tumor was located in the lower pole, metastasis rates of Ⅵ district was up to 74.29%, and Ⅱ-Ⅴ area were just 45%, while when the tumor was located in the upper pole, metastasis rates of VI district was 58.33%, and Ⅱ-Ⅴ regions were as high as 84.21%. Tumor diameters greater than 1cm and 2cm were the threshold of increased metastasis rates rising in the central and lateral neck districts respectively. Conclusion Mass in the lower pole, diameter >1 cm, multiple, multi-leaf involvement, leaching capsule and younger age could be taken as the risk factors for the central lymph node metastasis; While mass in the upper pole, diameter >2 cm, multiple, multi-leaf involvement and leaching capsule may be the risk factors for the lateral neck lymph node metastasis. We should pay particular attention to the relationship between tumor location and different regions of lymph node status as well as tumor volume critical value may be different when it is the risk factor for regional lymph node metastasis.