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<b>Purpose:</b> To explore the risk factors that may predict the lymph node metastasis potential of these lesions and new prevention strategies in papillary thyroid carcinoma patients. <b>Materials and Methods:</b> In total, 9,369 papillary thyroid carcinoma patients with 37.17% lymph node metastasis were analyzed (Revman 5.3 software) in this study. The PubMed and Embase databases were used for searching works systematically that were published through to January 22, 2020. <b>Results:</b> Several factors were related to the increased risk of lymph node metastasis in patients with papillary thyroid carcinoma: age <45 years (pooled OR = 1.52, 95% CI = 1.14-2.01, <i>p</i> <0.00001); gender = male (pooled OR = 1.68, 95% CI = 1.51-1.87, <i>p</i> <0.00001); multifocality (pooled OR = 2.05, 95% CI = 1.45-2.89, <i>p</i> <0.0001); tumor size ≥1.0 cm (pooled OR = 3.53, 95% CI = 2.62-4.76, <i>p</i> <0.00001); tumor location at the upper pole 1/3 (pooled OR =1.46, 95% CI = 1.04-2.04, <i>p</i> = 0.03); capsular invasion + (pooled OR = 3.48, 95% CI = 1.69-7.54, <i>p</i> = 0.002); and extrathyroidal extension + (pooled OR = 2.03, 95% CI= 1.78-2.31, <i>p</i> <0.00001). However, tumor bilaterality (pooled OR = 0.85, 95% CI = 0.54-1.34, <i>p</i> = 0.49) and Hashimoto's thyroditis (pooled OR = 1.08, 95% CI = 0.79-1.49, <i>p</i> = 0.62) showed no correlation with lymph node metastasis in papillary thyroid carcinoma patients. <b>Conclusion:</b> The systematic review and meta-analysis defined several significant risk factors of lymph node metastasis in papillary thyroid cancer patients: age (<45 years), gender (male), multifocality, tumor size (>1 cm), tumor location (1/3 upper), capsular invasion, and extra thyroidal extension. Bilateral tumors and Hashimoto's thyroiditis were unrelated to lymph node metastasis in patients with papillary thyroid cancer.