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Objective: We evaluated the relationship between the clinical management of level Ⅵ lymph node and neck lymph node micrometastases in follicular thyroid carcinoma. Methods: 326 negative neck lymph nodes of 68 cases with follicular thyroid carcinoma on routine pathology were examined by keratin-19 monoclonal antibody and S-P immunohistochemistry to confirm lymph node micrometastasis. Follow-up pathological and clinical documents were compared. Results:Forty-six neck lymph nodes showed positive micrometastasis among 326 negative neck lymph nodes including 4 lymph nodes in Level Ⅱ (4/42), 5 lymph nodes in Level Ⅲ (5/34), 5 lymph nodes in Level Ⅳ (5/49), 1 lymph node in Leve Ⅳ (1/17)and 31 lymph nodes in Level Ⅵ (31/184). Six in 14 cases with positive micrometastasis showed distant metastasis or local recurrence, but only 3 in 54 cases with negative micrometastasis indicated distant metastasis or local recurrence (P ＜ 0.01).Conclusion: The research showed that Level Ⅵ neck lymph node micrometastasis is possibly occur and closely related with local recurrence and metastasis in follicular carcinoma of thyroid.