ABSTRACT Objective To analyze the characteristics of two-dimensional ultrasound images of papillary thyroid carcinoma (PTC) and the relationship between BRAFV600E mutation and cervical lymph node metastasis. Methods 316 patients with thyroid cancer underwent radical surgery in our hospital were selected. According to the pathological stage (pTNM) of thyroid cancer after surgery, those without cervical lymph node metastasis (pN0) were classified as (non metastasis group), and those with cervical lymph node metastasis (pN1) were classified as (metastasis group). The differences of two-dimensional ultrasound image characteristics, clinical data and BRAFV600E mutation between the two groups were compared. Multi-factor logistic regression analysis was used to analyze the characteristics of PTC ultrasound image and the relationship between BRAFV600E mutation and cervical lymph node metastasis. ResuLts Among 316 PTC patients, 156 (49.4%) in the metastatic group, 98 (62.8%) had BRAFV600E mutation; 160 (50.6%) in the non-metastatic group, 121 (75.6%) had BRAFV600E mutation. There were statistically significant differences between the metastatic group and the non-metastatic group in terms of age, number and size of lesions, sand calcification, aspect ratio, tumor margin, the relationship between lesions and membrane,and involvement of glandular lobes (all P<0.05). Multivariate logistic regression analysis showed that patients' age, tumor size, sand calcification, aspect ratio, the relationship between lesion and membrane, and the involvement of glandular lobe were risk factors for pN1（all P< 0.05）. Conclusion The cervical lymph node metastasis of PTC is related to the patient's age, tumor size, sand calcification, aspect ratio, the relationship between the lesion and membrane, and the glandular lobe involved, but not to gender, number of lesions, tumor margin, and BRAF V600E mutation.