Whether chemotherapy is needed after lymph node metastasis of thyroid cancer needs to be comprehensively determined according to the patient’s situation. If lymph node metastasis is found before surgery for thyroid cancer, it is considered to be an advanced stage of malignant disease, and lymph node clearance is needed. After surgery, further radiotherapy, chemotherapy, targeted therapy and other comprehensive treatments can improve the effect of surgical treatment and reduce the recurrence rate after surgery. If lymph node metastasis is found after surgery, it needs to be comprehensively determined according to the patient’s physical condition. If the patient is generally in good physical condition and has the requirement for treatment, chemotherapy can be appropriate. If they cannot tolerate chemotherapy, they can choose symptomatic treatment to minimize the patient’s pain and improve the quality of life.