Microscopic thyroid carcinoma refers to malignant tumors of the thyroid gland ≤1.0 cm in diameter; given that the majority of thyroid carcinomas are papillary thyroid carcinomas, microscopic thyroid carcinoma refers to papillary microcarcinoma. In recent years, analysis of the SEER database has shown a significant increase in the prevalence of thyroid cancer, with a predominant increase in microscopic thyroid cancer, but no increase in mortality. In 2012, Pacini reviewed six studies of microscopic thyroid cancer and confirmed that more than 20% of microscopic thyroid cancers were multifocal, with an average of 11% having extraglandular invasion and 28% having lymph node metastases at the time of diagnosis. The latest treatment strategies for microscopic thyroid cancer still include surgery, radioiodine therapy and thyroid hormone therapy, but the specific strategies have changed in the latest guidelines. 1. Surgery: For a long time, total/near-total thyroidectomy has been the mainstream surgical procedure for thyroid cancer. However, several analyses based on the SEER database have also shown that the extent of thyroid surgery itself has no impact on patient survival after correcting for several prognostic factors such as age, length of diagnosis, pathological characteristics of the tumor, gender, and radioiodine treatment. In addition, two single-center studies have confirmed that long-term survival rates for patients with stage T1 and T2 thyroid cancer who undergo lobectomy alone are upwards of 98% if the indication is chosen appropriately. In the latest 2015 edition of the ATA guidelines, the indications for lobectomy have actually been further relaxed to low-risk (all of the following: no significant extra-glandular invasion, no cervical lymph node involvement or distant metastases, no family history of thyroid cancer, no history of head and neck radiation therapy, and age ≤45 years) differentiated thyroid cancer with a diameter of <4 cm can be treated with lobectomy only. The lobe of the thyroid gland can be excised. Radioactive iodine therapy: Whether to remove residual normal thyroid tissue (nail clearance) after surgery for microscopic thyroid cancer depends on the risk of recurrence based on clinical and postoperative pathological findings. In both single and multiple lesions, if the tumor is confined to the thyroid gland without lymph node metastases or distant metastases, radioactive iodine treatment need not be given. This view is recommended in the ATA 2009 and 2015 editions of the guidelines and in the 2012 edition of the Chinese guidelines. However, for microscopic thyroid cancer with lymph node metastasis, it is recommended that radioactive iodine therapy should be selected on a case-by-case basis. 3. Thyroid hormone therapy: Postoperative oral thyroid hormone suppression (TSH) is an important part of thyroid cancer treatment. In the latest version of ATA guidelines, TSH suppression therapy for low-risk thyroid cancer is significantly relaxed than before: if thyroglobulin (Tg) and thyroglobulin antibody (TgAb) are not measurable in postoperative serum, TSH control at 0.5-2.0 mU/L in the primary treatment period (usually means 1 year after surgery) is sufficient; if postoperative serum Tg is still measurable, the TSH target in the primary treatment period is 0.1 to If postoperative serum Tg is still measured, the TSH target is 0.1~0.5 mU/L in the initial treatment period; after that, if the patient responds well to treatment and there is no sign of recurrence, the TSH target is changed to 0.5~2.0 mU/L. In conclusion, microscopic thyroid cancer is a common endocrine malignant tumor, and a significant proportion of microscopic thyroid cancer has inert progression characteristics and poses little threat to survival, but a small proportion of microscopic thyroid cancer exhibits aggressive and metastatic characteristics, and its treatment and The treatment and management of this cancer should be rationalized and individualized.