Abstract: Objective To explore the efficacy and sefety of radiofrequency ablation guided by ultrasound in treatment of thyroid papillary tiny carcinoma. Methods Fifty-three patients underwent radiofrequency ablation guided by ultrasound in ultrasound diagnostics division of our hospital from July 2014 to February 2015. The focal size, neck lymph nodes and the thyroid parenchyma at different periods after radiofrequency ablation in patients with thyroid papillary tiny cancer were observed to analyze the effects of radiofrequency ablation technique in treatment of thyroid papillary small carcinoma. Results The volumes of the nodules decreased gradually after radiofrequency ablation with 1-, 3-, 6-, 12-month shrinkage rate of 21.51%, 51.16%, 84.29% and 92.27%. The nodule in 1 patient disappeared at 3 months after treatment, it completely disappeared in 4 patients after 6 months, and it disappeared in 12 patients at 1 year after treatment. Fifty two (98.4%) patients achieved diseasefree survival after radiofrequency ablation for the first time. There were 6 cases with neck ache (11.5%) and one case with a small amount of bleeding (1.9%) at the incision site. One patient was found to have primary focal local recurrence at 6 months after radiofrequency ablation, and 1 case was found to have neck lymph node metastasis at 12 months after treatment with the total recurrence rate of 3.76%. Conclusion The prognosis of thyroid papillary carcinoma is good after radiofrequency ablation treatment, with disease-free survival rate of more than 95% in this study, which suggests that radiofrequency ablation can treat thyroid papillary tiny cancer with certain effectiveness and safety.