Abstract: Objective To analyze the clinical presentation, pathological type, diagnosis, treatment and prognosis of primary thyroid lymphoma (PTL). Methods Clinical data about 20 cases with primary thyroid lymphoma admitted to Chinese PLA General Hospital from June 1993 to June 2013, including clinical manifestation, diagnosis procedure, treatment project and prognosis, were reviewed. According to the stage of primary thyroid lymphoma and whether accepted operation, patients with different pathological types were divided into different groups and their overall survival was analyzed. Results One case died of suffocation without treatment, 5 cases underwent chemotherapy or chemotherapy + radiotherapy after ultrasound guided puncture biopsy for diagnosis, 14 cases underwent operation, operation + chemotherapy or operation + chemotherapy + radiotherapy. The median follow-up time of all patients was 41 months (0-131 months), but the follow-up had not reached the end yet. Three MALT patients got long-term survival. The 2-year and 5-year survival rates ofⅠE stage DLBCL were 100% (5 cases) and 100% (5 cases) respectively. The 2-year and 5-year survival rates of ⅡE stage DLBCL were 72.9% (6 cases) and 58.3% (5 cases) respectively. The prognosis of DLBCL patients with stage ⅠE was better than ⅡE (P=0.048). The 2-year and 5-year survival rates of DLBCL patients underwent surgery were 74.1% (7 cases) and 74.1% (7 cases) respectively. The 2-year and 5-year survival rates of DLBCL patients without surgery were 100% (4 cases) and 75.0% (3 cases), which showed no significant difference between two groups (P=0.804). Conclusion MALT patients with treatment can get a long-term survival. The prognosis of stage ⅠE patients with DLBCL is better than that of stage ⅡE patients. Operation has no significant effect on the prognosis of patients with DLBCL. Surgical operation intervention should be chosen carefully.