Objective To discuss the relationship between thyroid stimulating hormone (TSH) and clinicopathologic features of the papillary thyroid microcarcinoma (PTMC) patients. Methods The thyroid nodules of 806 cases retrospectively that were for the first time hospitalized to our department in recent 5 years were collected, among them, postoperative pathological examination confirmed the diagnosis of PTMC in 403 cases, 403 cases of benign thyroid lesions, the history data of selected cases that meet the criterion of selection were retrospectively analyzed. TSH and anti thyroid globulin antibody (TGAb) levels between the 2 groups and the prevalence of ratio of PTMC in different TSH levels were compared. Univariate and multivariate analysis were performed to determine the risk factors of PTMC. Results The differences of preoperative TSH levels between the two groups was statistical significance (Z=–6.233,P=0.001), gender composition no statistical significance in two groups (χ2=3.246,P=0.072), and age was statistically significant (Z=–5.855,P=0.001). The constitution of ethnics of two groups was different (χ2=38.961,P=0.001). Logistic regression analysis display that age and TSH level were the independent risk factors of PTMC (age:OR=0.914,P=0.027; TSH:OR=4.662,P=0.008). Conclusions The level of serum TSH in PTMC patients is higher than in patients with benign thyroid nodules. TSH level is probably predictive of malignancy of PTMC.