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Objective To explore the value of trans-lymphatic contrast-enhanced ultrasound(CEUS)in the diagnosis of cervical lymph node metastasis of thyroid cancer. Methods The patients with suspected thyroid cancer underwent conventional ultrasound and trans-lymphatic CEUS examinations before the biopsy.The differences in ultrasound and CEUS characteristics of cervical lymph nodes between the metastatic group and the non-metastatic group were compared,and pathological results were regarded as the golden standard. Results Twenty patients had thyroid cancer,including 12 cases with lymph node metastasis and 8 cases without metastasis.The diagnostic sensitivity(91.7% vs. 75.0%)and accuracy(90.0% vs. 80.0%)of trans-lymphatic CEUS were higher than those of conventional ultrasound.The normal lymph nodes presented homogeneous enhancement,while the metastatic lymph nodes showed heterogeneous or non-enhancement during the trans-lymphatic CEUS examination.Conclusion As a new modality of ultrasound,trans-lymphatic CEUS contributes to the diagnosis of cervical lymph node metastasis of thyroid cancer and supplements the deficiencies of conventional ultrasound.