Objective: To explore the influenced variate on central lymph node (CLN) metastases in patients with thyroid carcinoma and to evaluate the diagnosis ability about central lymph node metastases with ultrasonography. Methods: Of 284 patients, 145 had CLN metastases, who were identified as thyroid carcinoma by pathological diagnosis retrospectively. Logistic regression was used to analyze the multivariate about central lymph node metastases in this article, such as age, sex, maximal tumor size, type of nodule distribution and calcification in or not in the nodule. In addition, we collected patient’s preoperative ultrasonic images to evaluate the diagnosis ability about central lymph node metastases with ultrasonography. Results: The rate of CLN metastasis was considerably higher in cases of age younger than 45 years old (P<0.001; OR=0.342), of maximal tumor size greater than 5 mm (P=0.016, OR=1.692), and of the type of multifocality; however, sex and calcification had no influence on CLN metastases (both P>0.05). There was obvious advantage that ultrasonography was used to diagnosis ipsilateral thyroid carcinoma, whose sensitiveness was 90.8% and 90.6%, but bilateral thyroid carcinoma had lower sensitiveness which just was 67.2%. The sensitiveness of finding CLN metastases was 42.1% with ultrasonography, but which was higher in the type of multifocality, about 53.5%. Conclusion: Age younger than 45 years old, maximal tumor size greater than 5 mm and the type of multifocality are independent influenced variate for CLN metastasis; ultrasonography is expected to improve the ability of finding bilateral thyroid carcinoma and CLN metastasis.