Background: The papillary carcinoma thyroid is a rare disease in adolescents and children. A high level of suspicion should arouse as soon as the physician comes across swelling in neck. Appropriate management yields a good survival rate. Case history: We present a case of the papillary carcinoma thyroid in a 13-year old girl presented to outdoor of Jinnah Hospital, Lahore with painless swelling in right side of neck for three months. There were associated smaller swelling matted on palpation. No history of palpitations, fever, weight loss and family history of tuberculosis contact or cancer in family. Initial radiology and blood investigations showed an euthyroid goitre. The fine needle aspiration of lymph node only showed reactive hyperplasia. The matted lymph node was partially excised for histopathology as suspicion of tuberculosis existed due to its endemic feature. Later, it was found to be papillary carcinoma of thyroid. Total thyroidectomy was done with neck dissection followed by treatment at nuclear medicine department. Conclusion: Thyroid cancer is quite uncommon in adolescents but strong suspicion should arise when dealing with neck swelling even in this age group. Thorough history, watchful physical examination and timely investigations can save clinician from missing the diagnosis.