Objective:To investigate the relationship between ultrasonic gray scale sonogram features of papillary thyroid microcarcinoma(PTMC) and cervical lymph node metastasis(LNM),and to analyze the predictive value of ultrasonic gray scale sonogram features on cervical LNM in PTMC.Methods:83 patients with PTMC admitted to our hospital from May 2016 to May 2018 were enrolled in this study.All the subjects were examined by gray scale ultrasonography.The characteristics of gray scale ultrasonography were analyzed,and the relationship between gray scale ultrasonography and cervical LNM was observed by regression analysis.Results:Sex,age,lesion diameter,location,aspect ratio,type of internal calcification,relationship with capsule and whether microcalcifications exceed nodules were all related to cervical LNM(P<0.05).The edge and internal echoes in ultrasound gray scale sonographic features were not related to neck LNM,P>0.05.Multivariate regression analysis showed that sex,age,lesion diameter,location,aspect ratio,type of internal calcification and whether microcalcification exceeded nodules were not related to LNM,P>0.05.The relationship only with the capsule is related to the LNM of the neck,P<0.05.Conclusion:Ultrasonic gray scale sonogram has certain predictive value for the occurrence of cervical LNM in PTMC patients.When PTMC lesions touch the capsule,central lymph nodes should be removed during operation.