Abstract: Objective To generalize the characteristics of papillary thyroid microcarcinoma(PTMC) in gross view and microscopic observation, to improve the accuracy of diagnosis. Methods We collected and analyzed statistically the data of 129 patients diagnosed as PTMC by conventional and quick pathological diagnosis, including descriptions in gross view, frozen section and routinely paraffin-embedded section. Results (1) The diagnostic technology of PTMC was mature; the coincidence rate of diagnosis based on frozen section and routinely paraffin-embedded section was 97.67%; (2) PTMC could happen only on the left, right or both sides, but there was no statistically significant difference (34.9% vs. 38.0% vs. 27.1%, P=0.1630). And the number of patients with single tumor diameter ≤0.5cm was obviously more than that ＞0.5cm (63.6% vs. 36.4%, P=0.0000). There were statistically significant difference among groups with 1, 2 and >2 lesions(84.5% vs. 8.5% vs. 7.0%, P=0.0000), hard and soft tumor (85.3% vs. 14.7%, P=0.0000), white and light red section of tumors (94.6% vs. 5.4%, P=0.0000), with and without star-like-scar appearance (60.5% vs. 39.5%, P=0.0008). There was a general decrease in the incidence of basic lesions: nodular goiter, hashimoto thyroiditis, other lesions and adenoma with cystic degeneration (48.1% vs. 22.5% vs. 15.4% vs. 14.0%, P=0.0000). (3) In the frozen section's microscopic observation, the key clues of diagnosis were the higher tensive and expansive glands invaded in the fibrous and sclerotic background. Intranuclear inclusions and psammoma bodies or calcification were helpful for diagnosis. Conclusion Quick pathological diagnostic technology in operation is the most important method to diagnose PTMC. Correctly identifying the typical characteristics in gross and microscopic view is effective to improve the diagnostic accuracy.