Objective To investigate the correlation between the two-dimensional ultrasound features and quantitative parameters of SWE of papillary thyroid microcarcinoma(PTMC) and central lymph node metastasis(CLNM).Methods Patients with PTMC who underwent thyroidectomy and central lymph node dissection underwent two-dimensional ultrasonography and SWE before surgery. They were divided into metastatic group (46 cases) and non-transfer group(70 cases) according to CLNM, the correlation between PTMC two-dimensional ultrasound features and SWE quantitative parameters and CLNM was analyzed. Results The differences between Emax and Emean in PTMC patients were statistically significant (P<0.05).The ROC curve analysis showed that the areas under Emax and Emean curves were 0.851 and 0.752. Emax43.35kPa and Emean30.15kPa were used as diagnostic thresholds respectively, and their diagnostic sensitivity and specificity were 87%, 72.9%, and 78.3%, 61.4%.The results of single factor analysis showed that multiple, marginal irregularities, irregular morphology, microcalcification, invasion of the capsule, and Emax were risk factors for CLNM of PTMC (P<0.05). Multivariate logistic regression analysis further showed that multiple, invasive capsules and Emax values were independent risk factors for CLNM of PTMC (P<0.05).Conclusion SWE can predict the CLNM of PTMC, and when there were multiple foci, invasion of the capsule and Emax>43.43 kPa, the risk of CLNM of PTMC was significantly increased,preventive central lymph node dissection is recommended .