Objective To explore the evaluation value of contrast-enhanced ultrasound through lymphatic vessel (LCEUS) and ultrasonic shear wave elastography (SWE) in central compartment lymph node metastasis of thyroid carcinoma (TC). Methods A total of 70 patients with TC confirmed in the hospital were enrolled between February 2020 and February 2023. According to presence or absence of lymph node metastasis, they were divided into metastasis group (n=30) and non-metastasis group (n=40). All underwent LCEUS and SWE. LCEUS parameters (perfusion order, perfusion mode, arrival time, time to peak, peak intensity) and SWE parameters [the maximum Young modulus (Emax), the minimum Young modulus (Emin), mean Young modulus (Emean)] were compared. The diagnostic efficiency of LCEUS and SWE for central compartment lymph node metastasis of TC was analyzed by receiver operating characteristic (ROC) curves. Results There were significant differences in LCEUS parameters (perfusion order, perfusion mode, arrival time, time to peak, peak intensity) between metastasis group and non-metastasis group (P<0.05). SWE parameters (Emax, Emin, Emean) in metastasis group were higher than those in non-metastasis group (P<0.05). ROC curves analysis showed that AUC, sensitivity and specificity of arrival time, time to peak, peak intensity, Emax, Emin, Emean and combined detection in the diagnosis of central compartment lymph node metastasis were (0.582, 0.698, 0.771, 0.861, 0.660, 0.757, 0.764), (70.00%, 66.70%, 76.70%, 86.70%, 76.70%, 78.00%, 90.00%) and (40.00%, 62.50%, 67.50%, 85.00%, 60.00%, 62.50%, 57.50%), respectively. Conclusion LCEUS combined with SWE has high sensitivity and clinical value in the diagnosis of central compartment lymph node metastasis of TC.