Abstract: Objective To explore the surgical treatment and prognostic factors of differentiated thyroid cancer in children and adolescents. Methods Clinical data about 46 children and adolescents with differentiated thyroid cancer （DTC） admitted to the First Medical Center of Chinese PLA General Hospital From January 2015 to December 2019 were retrospectively analyzed and analysis of risk factors related to postoperative recurrence was performed. Results Among the 46 patients,there were 12 males and 34 females,aged 8-18 （15.48±2.35） years old.All patients were treated with surgery and followed up for 5 to 59 months.Twelve cases relapsed after operation.Univariate analysis showed extraglandular invasion,central lymph node metastasis,lateral lymph nodes metastasis,multifocal lesion and postoperative radioactive ¹³¹I treatment were correlated with the recurrence （OR>1）.Multivariate analysis showed that multifocal （OR=4.441,P=0.046） and extraglandular invasion （OR=15.944,P=0.012） were independent risk factors for recurrence. Conclusion Tumor multifocality and extra-gland invasion are independent risk factors for children and adolescents with DTC.