Objective <p>Exploring the role of nodule location in the diagnosis of papillary thyroid carcinoma in Chinese patients.</p> Methods <p>This study is a retrospective analysis of thyroid nodule patients who underwent surgery in our hospital from Jan 2022 to Dec 2023. The ultrasound characteristics of thyroid nodules in all patients were analyzed by matching them one-to-one with the postoperative pathological results.</p> Results <p>Four hundred and seven patients and 496 nodules were included in the analysis of this study. There were 320 female patients (78.6%) and papillary thyroid carcinoma were 312 (62.9%). Univariate analysis found that except for age and nodule size, other factors have statistical significance in the diagnosis of papillary thyroid carcinoma. Especially for isthmus nodule, the risk for malignant tumor was particularly high. When these factors were taken into multivariate logistic regression, the location of the isthmus still had statistical significance in the risk of malignancy. Meanwhile, the location of thyroid nodule could provide more reference information for the active surveillance of low-risk papillary thyroid carcinoma patients.</p> Conclusion <p>Thyroid isthmus nodule has a higher likelihood of malignancy. During the active surveillance process in low-risk papillary thyroid carcinoma patients, attention should be paid to the dynamic changing in the location of thyroid nodule.</p>