This study investigated whether insulin-like growth factor 1 receptor (IGF1R) single-nucleotide polymorphisms (SNPs) are associated with the development of papillary thyroid cancer (PTC) and their clinicopathologic features in the Korean population. One hundred and five PTC patients and 312 control subjects were enrolled. Two exonic SNPs (rs3743262, Thr766Thr; rs2229765, Glu1043Glu) in IGF1R were genotyped using direct sequencing. SNPStats, SPSS 18.0, and Haploview version 4.2 programs were used to evaluate genetic data. Multiple logistic regression models were used to determine odds ratios (ORs), 95% confidence intervals (CIs), and P values. A SNP (rs2229765) was associated with the development of PTC (OR = 0.56, 95% CI = 0.35-0.89, P = 0.016 in a codominant model 1; OR = 0.29, 95% CI = 0.11-0.78, P = 0.012 in a codominant model 2; OR = 0.51, 95% CI = 0.32-0.79, P = 0.0028 in a dominant model; OR = 0.38, 95% CI = 0.15-1.01, P = 0.031 in a recessive model; OR = 0.55, 95% CI = 0.38-0.80, P = 0.0001 in a log-additive model; OR = 1.78, 95% CI = 1.25-2.54, P = 0.002 in allele distribution). Our data suggest that the IGF1R may be a risk factor of susceptibility in PTC.