Papillary thyroid cancer is more prone to lymph node metastasis, most commonly in the central lymph nodes, with metastasis appearing early but with a better prognosis. Meanwhile, symptoms such as neck enlargement, contralateral and distant metastasis may occur. 1. Enlargement of the neck may cause compression symptoms. 2. Enlargement of lymph nodes, if the lymph nodes cross the peritoneum and infiltrate each other, or invade neighboring blood vessels, nerves, and surrounding tissues, it may affect the effect and completeness of the subsequent surgery, especially when lymph node dissection is required, which may cause complications such as lymphedema. 3. Contralateral metastasis, if unilateral lymph node metastasis is not treated, contralateral lymph node metastasis will occur, which will lead to the spread of cancer cells from the opposite side of thyroid gland lobes. 4. Distant metastasis, which needs to be emphasized and evaluated as soon as possible. In conclusion, metastatic lymph of papillary thyroid cancer is a more serious situation, which should be consulted as soon as possible, treated according to doctor’s instructions and regularly reviewed.