In the past 30 years, the incidence of thyroid carcinoma (TC) has been increasing globally. As the main histological type of TC, the detection rate of papillary thyroid carcinoma (PTC) has been increasing year by year, and it has become the head and neck. One of the most common malignant tumors in surgery. Research on the mechanism of PTC by domestic and foreign scholars has become a hotspot in clinical and basic research. Its occurrence and development process involves a variety of genetic and epigenetic changes. Among them, B type serine/threonine protein kinase (BRAF) and rat sarcoma gene (RAS) point mutations and RET protooncogene (RET) rearrangement occur frequently in PTC. In addition, there are rare gene fusions that are also involved in the formation of PTC. Therefore, the following systematic overview of the genetic changes involved in the formation of PTC, the molecular mechanism of pathogenicity, and their relationship with clinical invasiveness characteristics is now made.