Objective To investigate the postoperative lateral lymph node recurrence of papillary thyroid carcinoma(PTC)and its related factors.Methods The clinical and pathological data of 1 229 patients with papillary thyroid carcinoma who underwent surgery in Xiangyang Central Hospital from January 1,2018 to December 31,2022 were retrospectively collected.Results A total of 1229 patients'data were obtained,including 70 patients in the recurrence group and 1159 patients in the non-recurrence group.Multivariate COX proportional hazards regression analysis showed that tumor size(HR:0.497,95%CI:0.287-0.858),the number of primary tumors(HR:2.037,95%CI:1.209-3.433),capsular invasion(HR:0.476,95%CI:0.251-0.903),extracapsular invasion(HR:0.332,95%CI:0.169-0.657)were the influencing factors of postoperative recurrence in patients with papillary thyroid carcinoma.The proportion of central lymph node metastasis had a good predictive value in multivariate COX regression analysis(P<0.05),and the cut-off value of the proportion of central lymph node metastasis determined by ROC curve was 23.6%.Conclusions Multiple primary lesions,tumor size>1 cm,capsular or extracapsular extension are risk factors for recurrence of papillary thyroid carcinoma after surgery.In clinical practice,the proportion of central lymph node metastasis ≥23.6%has a good predictive effect on the risk of postoperative lateral lymph node recurrence.