Objective To explore the value of contrast-enhanced ultrasound guide fine-needle aspiration cytology (CEUS-FNAC) in the diagnosis of lateral cervical lymph nodes (LCLNs) metastasis in papillary thyroid carcinoma (PTC). Methods Retrospective analyzed 128 PTC patients who accepted preoperative FNAC and thyroidectomy in Xiaogan Hospital affiliated Wuhan science and technology university during Sep. 2017 to Sep. 2019 were randomly divided into two groups.113 suspicious LCLNs of 64 patients in control group underwent conventional ultrasound guide fine-needle aspiration cytology (US-FNAC), 118 suspicious LCLNs of the other 64 patients in experimental group underwent CEUS-FNAC, the sensitivity, specificity and accuracy of US-FNAC and CEUS-FNAC in the diagnosis of LCLNs were compared. The diagnosis value of different size (￡10mm or >10mm) of LCLNs by US-FNAC and CEUS-FNAC were analyzed. Result The sensitivity, specificity and accuracy of CEUS-FNAC in the diagnosis of LCLNs (90.2%、93.5%、91.5%) were significantly higher than those of US-FNAC (72.3%、79.2%、75.2%) (all P < 0.05). When the size of LCLNs ￡10mm, the sensitivity and accuracy of CEUS-FNA were higher than US-FNA (P < 0.05), but there was no significant difference of specificity (P = 0.181) ; when the size of LCLNs >10mm, there were no significant difference in the sensitivity, specificity and accuracy of the two methods (all P > 0.05). Conclusion CEUS-FNAC would favorable to improve the diagnosis accuracy of lateral metastatic lymph nodes, providing effective information for surgical treatment.