The incidence of thyroid cancer is increasing year by year, with papillary thyroid cancer (PTC) accounting for the majority of cases. Although thyroid tumors are very prone to metastasis to the cervical lymph nodes, their prognosis is relatively good. A growing body of evidence confirms that lymph node metastasis has an adverse effect on both the prognosis and recurrence of thyroid cancer. Typically, metastasis from papillary thyroid cancer usually occurs first in the central lymph node region of the neck (VI) and then extends to the lateral side of the neck. However, there are exceptions. So, in papillary thyroid cancer, is central lymph node transformation a predictor of lymph node metastasis in the lateral cervical region? The investigators searched Pubmed, EMBASE and China Knowledge Network (CNKI) databases, and two investigators independently extracted and evaluated the relevant data, which were combined by a random-effects model. Twenty-one publications were included, and the study was heterogeneous in that the chance of lateral cervical lymph node metastasis was significantly higher in the central zone lymph node positive group than in the central zone lymph negative group. Subgroup and sensitivity analyses suggested that the study results were consistent and reliable. However, Begg’s funnel plot and Egger’s linear regression suggested the possibility of publication bias. This Meta-analysis suggested that central zone lymph node metastasis in the neck was predictive of lateral cervical lymph node metastasis in patients with papillary thyroid cancer. Patients with central zone lymph node metastasis had a significantly higher rate of lateral cervical zone lymph node metastasis than those with negative central zone lymph nodes, so special attention is needed for patients with central zone lymph node metastasis. Further research is needed on how to treat patients with a high risk of lateral cervical lymph node metastasis.