Differentiated thyroid carcinoma (DTC) exhibits an indolent progression and a favorable prognosis, but it is prone to early cervical lymph node metastasis (LNM), which is closely associated with postoperative recurrence and poor prognosis. High-resolution ultrasound, CT scanning, and fine-needle aspiration biopsy are commonly used methods for preoperative assessment of the presence and extent of cervical LNM. With the development of molecular biology techniques, significant progress has been made in the understanding of molecular mechanisms related to the prognosis of DTC. It holds the promise of providing new non-invasive and accurate ways to preoperatively assess cervical LNM, individualize surgical plans, and reduce unnecessary lymph node dissection. Here, the authors, based on current clinical research, summarize and discuss the relationship between molecular biomarkers and cervical LNM in DTC, as well as their potential value in diagnosis and prognosis.