To determine thyroid lymph node metastasis, it is mainly through pathological puncture biopsy and combined with clinical symptoms and routine examination. If lymph node metastasis occurs after thyroid cancer, it will often lead to obvious enlargement in the lymph node area, and most of them are painless neck nodes with poor mobility. If it is caused by normal lymph node inflammation, the activity is better and accompanied by obvious pressure pain. Pathologic puncture biopsy needs to be taken in time to clarify the benign or malignant nature of the nodes. In addition, ultrasound examination of the neck is also needed. If the thyroid gland causes lymph nodes, it often leads to compression symptoms of the peripheral nerves as well as blood vessels, and even causes headache, and it can be found that the lymph nodes have the phenomenon of sand-like calcification or punctate calcification during the examination. In addition to removing the thyroid gland in thyroid cancer surgery, it is also necessary to clear the nearby lymph nodes and do pathological examination to clarify whether there is any metastasis. Thyroid cancer patients with enlarged peripheral lymph nodes must go to the hospital in time and cooperate with the doctor’s examination for early diagnosis and treatment.