Objective：To evaluate the necessity of neck dissection for papillary thyroid microcarcinoma. Methods：The clinicopathologic data of 69 patients with papillary thyroid microcarcinoma treated in our hospital from May 1999 to October 2009 were analyzed. Of the patients, 42 cases were unifocal and 27 cases were multifocal. All patients underwent thyroidectomy and central compartment (level Ⅵ) and ipsilateral or bilateral deep lymph nodes (levels Ⅲ and Ⅳ) dissection. Results：In patients of unifocal and multifocal tumor, the metastasis of central compartment lymph nodes was found in 2(4.8%) and 7(25.9%) cases, and of deep lymph nodes was in 0 (0) and 3 (11.1%) cases, respectively. The metastasis rates of central compartment and deep lymph nodes were both significantly different between patients with unifocal and multifocal tumor (both P＜0.05). Four cases of temporary hypocalcemia, three cases of temporary recurrent laryngeal nerve paralysis and one case of lymphatic fistula occurred postoperatively. Recurrence occurred in one unifocal case 42 months later and one multifocal case 7 months later. No death occurred during the follow-up period of all patients. Conclusions：Neck dissection should be aggressively performed in patients with multifocal papillary thyroid microcarcinoma. However, prophylactic neck dissection is not necessary for unifocal cases under regularly follow-up care, because that has no influence on the survival rate but can improve quality of life.