〔Abstract〕 Objective To investigate the value of intraoperative exploration in guiding central lymph node dissection of Stage cN0 thyroid papillary microcarcinoma (TPMC). Methods A total of 922 patients with TPMC stage cN0 admitted to Fujian Provincial Jinshan Hospital from January 2017 to January 2020 were selected as the research subjects. The existence of lymph node metastasis in central region was determined by using postoperative pathological results as the gold standard to calculate the diagnostic efficacy of surgeons' intraoperative exploration for lymph node metastasis in central region. The maximum size of metastatic lymph nodes and the number of metastatic lymph nodes were analyzed. Results In this study, out of the 922 TPMC patients, 302 cases (32.8 %) had lymph node metastasis in the central region. The sensitivity, specificity, positive predictive value and negative predictive value were 23.84 %, 77.26 %, 33.80 % and 67.56 % respectively. The false negative rate of intraoperative exploration in patients with the largest metastatic lymph node diameter ≥ 5 mm was significantly lower than that in patients with the largest metastatic lymph node diameter < 5 mm, the difference was statistically significant (P < 0.001). There was no significant difference in the false negative rate of intraoperative exploration among patients with different number of metastatic lymph nodes (P > 0.05). Conclusion The sensitivity and specificity of intraoperative exploration in the diagnosis of lymph node metastasis in the central region of stage cN0 TPMC are both low. Therefore, the value of intraoperative exploration in guiding lymph node dissection in the central region of stage cN0 TPMC is limited.