Abstract: Objective To study the diagnosis and treatment of thyroid papillary microcarcinoma (TPMC). Methods Clinical data about 88 pathology-confirmed TPMC patients admitted to our department from January 2008 to January 2012 were retrospectively analyzed. Results The TPMC patients were diagnosed by fine needle biopsy under ultrasonic guidance, with a missed diagnosis rate of 15.9% and an intraoperative fast freezing missed diagnosis rate of 6.6%. Of the patients who underwent surgical treatment, 5 underwent therapeutic central compartment lymph node dissection, 6 underwent prophylactic central compartment lymph node dissection, and 5 were eventually diagnosed with cervical metastasis. The patients were treated with oral euthyrox tablets after operation and followed up for 3-56 months during which TPMC recurred only in 2 patients. Conclusion Attention should be paid to the clinical features of TPMC. Correct diagnosis and standard procedure are the key to its treatment.