Background: Pediatric thyroid cancer is an uncommon malignancy. Though rare it is treatable and has an excellent prognosis. The disease characteristics are different among children and adults. In children the disease is aggressive at presentation and often associated with lymph node metastasis, extracapsular extension and a higher incidence of multifocality. This report adds to the few studies detailing thyroid cancers in children. Clinical Description: 12 year old girl presented with swelling in anterior aspect of neck for the past six months. It was a diffuse swelling with an insidious onset. It gradually increased to the present size. She had no family history of thyroid cancer or any history of exposure to radiation. On examination, child had pallor, lymphadenopathy. The thyroid gland was diffusely enlarged and firm with a hard nodule on the left lateral aspect. Management: She had normal thyroid function tests and highly elevated anti-TPO levels. USG thyroid showed evidence of papillary carcinoma in a background of thyroiditis and bilateral cervical lymphadenopathy. FNAC confirmed the diagnosis. CT evaluation revealed mediastinal lymph nodes. The child underwent total thyroidectomy with modified neck dissection. Conclusion: Though an aggressive malignancy at presentation with meticulous treatment it is curable, has an excellent prognosis, and can avoid complications