Objective The study evaluated the factors affecting CLNM in patients with papillary thyroid microcarcinoma.Methods A retrospective cohort study was conducted with data obtained from patients with PMC between January 2011 and June 2016.We reviewed the ultrasound and pathology records of patients and analyzed the association between CLNM and ultrasound features of PMC.Results The univariate analysis (χ2test) showed that a number of factors were significantly associated with CLNM in PMC (P<0.05): male gender ,tumor size(>5mm), multifocality，microcalcification，no well-defined margin，the tumor contacted with the adjacent capsule of thyroid，rich vascularity, tumor located at the upper pole.The multivariate analysis (regression binary logistic) showed that male genderand the tumor contacted with the adjacent capsule of thyroid are associated with the neck lymph node metastasis in PMC(P<0.05). Conclusions Male gender and the tumor contacted with the adjacent capsule of thyroid has definite value in predicting CLNM for PMC patients.