Objectives: To determine the frequency and localization of regional neck metastases in patients with papillary thyroid cancer after total thyroidectomy with selective neck dissection who were treated at the Ear, Nose and Throat Clinic with Head and Neck Surgery of KBC Split in the period from January 1st 2018 until December 31st, 2022. Materials and methods: a retrospective study was conducted on 54 subjects treated at the Clinic for Ear, Nose and Throat Diseases with Head and Neck Surgery of University Hospital of Split in the period from January 1st 2018 to December 31st 2022. The subjects were diagnosed with papillary thyroid cancer and underwent total thyroidectomy with selective neck dissection and proven regional metastatic disease. The archives were analyzed and the obtained data are based on the medical history and pathohistological findings Results: The results of this study show that the most common localization of regional metastases of papillary thyroid carcinoma is region VI with 91% of metastases, followed by regions IV (43%), III (39 %), Vb (32%) and II (28%). A higher frequency of metastases in neck regions was found in males compared to females. 64% of positive lymph nodes out of 392 were also found in region VI. statistically significant difference was observed in extrathyroidal spread in comparison to patients younger and older than 55 years (P=0.008). Conclusion: It was found that papillary carcinoma is prone to lymphogenic metastatic spread, most often in the central regions of the neck. Male gender was shown to be a predictor for more frequent and numerous regional metastases.