Objective To explore the prediction model of cervical central lymph node metastasis (CLNM) in patients with clinical lymph node negative (cN₀) papillary thyroid microcarcinoma (PTMC).Methods A total of 1 271 cN₀-PTMC patients diagnosed by the Department of Otolaryngology Head and Neck Surgery of the First Affiliated Hospital of Xi’an Jiaotong University from 2015 to 2020 were enrolled in this study. According to the surgical records and postoperative pathological results, the clinicopathological data such as age, sex, maximum tumor diameter, tumor location, lateral type, concomitant nodular goiter (NG) and hashimoto’s thyroiditis (HT), extraglandular invasion, capsule invasion and neck lymph node metastasis were calculated, and the correlations between CLNM and the clinicopathological parameters were analyzed.Results The age of 45 years was used as the classification standard for univariate analysis. The results showed that the incidence of CLNM in cN₀-PTMC was associated with male, age, tumor diameter, whether or not concomitant HT and multiple foci (P＜0.05). The incidence of CLNM in cN₀-PTMC was not associated with concomitant NG, BRAF^V600E gene mutation, tumor location, extraglandular invasion, lateral type and capsule invasion (P＞0.05). Unconditional Logistic regression analysis showed that male (OR=1.929, 95%CI:1.465-2.541), ≤45 years old (OR=2.581, 95%CI:2.004-3.324), multiple foci (OR=1.675, 95%CI:1.276-2.197) were independent risk factors for CLNM in cN₀-PTMC patients. Tumor diameter ≤5 mm (OR=0.603, 95%CI:0.463~0.785) and concomitant HT (OR=0.642, 95%CI:0.452~0.913) were protective factors for CLNM in cN₀-PTMC patients. Concomitant HT was the risk factor for the wild type of BRAF^V600E gene in cN₀-PTMC patients (OR=3.454,95%CI:1.865~6.397).Conclusion Male, ≤ 45 years old, tumor diameter > 5 mm, without HT and multiple foci are independent risk factors for CLNM in cN₀-PTMC patients. Concomitant HT is a protective factor for BRAF^V600E gene mutation in these patients, and there are no correlations with other clinicopathological features.