BackgroundHashimoto's thyroiditis' (HT) impact on the aggressive lymph node (ALN) status of papillary thyroid carcinoma (PTC) remains understudied.MethodsUnivariate and multivariate analyses assessed PTC aggressiveness markers, comparing PTC + HT to PTC alone from a single center retrospectively. ALN categorization included > 5 positive, ≥ 1 > 3 cm, and/or ≥ 4 with extranodal extension lymph nodes.ResultsOf 533 patients with PTC, 19.1% concurrently had HT. Compared to PTC alone, PTC + HT patients were predominantly female (p < 0.001), younger (p = 0.034), non‐smokers (p = 0.035), and had more pN0 stage tumors (p < 0.001). PTC + HT was associated with lower odds of pN1 stage (ORadj, 0.50) and lymphatic invasion (ORadj, 0.53). No significant differences were observed in ALN status, pT stage, lymphatic and perineural invasion, gross ETE, margin, and focality.ConclusionALN status does not differ between PTC with or without HT.