In recent years, the rapid increase in incidence of papillary thyroid microcarcinoma (PTMC) worldwide has spurred great attention and even disputes in its diagnosis and treatment. At present, two strategies for diagnosis and treatment of PTMC have been proposed by some scholars at home and abroad: one is “overdiagnosis and overtreatment”, and the other is “active surveillance and delayed intervention”. However, by taking an integrated account of the characteristics of PTMC, patients’ preferences, and medical circumstances and resources, “active surveillance and opportunistic intervention” is considered to be the best strategy to date.