OBJECTIVE: To explore the clinical characteristics, diagnosis and therapy of thyroid carcinoma in children. METHODS: Clinical data of 12 children under the age of 14 years, diagnosed as thyroid carcinoma between August 1998 and August 2008, were reviewed. RESULTS: A hard thyroid mass was observed in 10 out of 12 children with thyroid carcinoma, but only one out of 15 children with benign thyroid tumor (P<0.05). The rate of cervical lymph node metastasis in children with thyroid carcinoma was significantly higher than that in children with benign thyroid tumor (P<0.05). There was no significant difference in the final diagnostic rate of thyroid carcinoma between ultrasonography and CT scans (75% vs 83%; P>0.05). All of 12 cases were pathologically confirmed as differentiated thyroid carcinoma, including papillary carcinoma (7 cases), follicular carcinoma (3 cases) and papillary-follicular carcinoma (2 cases). Nine patients (75%) had cervical lymph node metastasis. All patients received surgical treatment and postoperative thyroxin therapy. No patient was administered with postoperative radioiodine 131I therapy. Unilateral lobectomy plus isthmectomy along with a functional cervical lymph node dissection was a primary operation mode (83%). The follow-up period was 2 months to 10 years. The 5-and 10-year survival rates were 100%. CONCLUSIONS: Childhood thyroid carcinoma is mostly differentiated and characterized by hard thyroid mass and cervical lymph node metastasis. A combination of ultrasonography and CT is helpful to the diagnosis of childhood thyroid carcinoma. The treatment outcome may be satisfactory by optimal therapy in children with thyroid carcinoma.［Chin J Contemp Pediatr, 2009, 11 (2):120-123］