Objective To investigate the correlation between the characteristics of clinic, gray-scale sonography and contrast-enhanced ultrasound of solitary papillary thyroid carcinoma(PTC) and central lymph node metastasis(CLNM). Methods Retrospective analysis of 290 cases of solitary PTC examined by our hospital and confirmed by surgical pathology based on the inclusion and exclusion criteria from January 2018 to February 2023. All cases was divided into the group with metastasis (114 cases) and without metastasis (176 cases) according to the presence or absence of CLNM. Relevant clinical and ultrasound features were recorded, univariate and multivariate logistic regression analyses were applied to analyze the correlation. Meanwhile, receiver operator characteristic (ROC) curve was plotted to assess the efficacy. Results Univariate analysis suggested that gender, age, hashimoto’s thyroiditis(HT), nodule size, composition, echo homogeneity, A/T, microcalcification, perinodular thyroid perineural continuity, enhancement degree and enhancement uniformity were related with CLNM(all P < 0.05). Logistic regression analysis showed that male, less than 35 years old, nodule size larger than 1.00cm, microcalcification and interruption of the perinodular thyroid peritoneum were independent risk factors of CLNM in solitary PTC; HT (OR=0.312) was a protective factor for CLNM(P < 0.05). The AUC of the ROC curve was 0.864 (95% CI 0. 823-0.906), sensitivity 86.0% and specificity 76.1%. Conclusions When patients with solitary PTC are male, less than 35 years, nodule size larger than 1.00 cm, with microcalcifications and interrupted thyroid perineurium, the risk of CLNM is promoted. HT is a protective factor against CLNM.