OBJECTIVE: Micro papillary thyroid carcinoma (MPTC), a variant of papillary thyroid carcinoma (PTC) sized ≤10 mm, is increasingly detected due to advanced ultrasound. This study aimed to describe characteristics and risk assessment of patients with Micro papillary thyroid carcinoma to predict outcomes and guide initial management. METHODS: This retrospective cohort study (June 1980 - September 2023) assessed patients with MPTC using 2015 ATA (American Thyroid Association) guidelines for risk stratification and determination of response to treatment. Outcomes ranged from excellent to structural incomplete responses. RESULTS: Among 208 patients with PTC with a primary tumor focus ≤10 mm, 68.8% were low-risk, 29.3% intermediate-risk, and 1.9% high-risk. Higher risk was linked to larger tumor size (≥7 mm) (OR=3.196, p-value=0.001) and multifocality (OR=2.431, p-value=0.004). Age (OR=0.973, p-value=0.048) and background Hashimoto's thyroiditis (OR=0.439, p-value=0.014) was found as protective factors. Excellent response to therapy observed in 48.4% of patients
while structural and biochemical incomplete responses were found to be 11.2% and 7.5%. Recurrence was detected in 14 (8.18%) patients. CONCLUSION: MPTC generally has a good prognosis and responds well to the treatment. Larger tumors (≥7 mm), younger age (<
40 years), multifocality and absence of Hashimoto's thyroiditis correlate with a higher ATA risk and poorer outcomes.