BACKGROUND We developed a model based on ultrasound (US) features of thyroid nodules and cervical lymph nodes to distinguish papillary thyroid carcinomas (PTC) from benign thyroid nodules. MATERIAL AND METHODS We retrospectively collected data on preoperative ultrasonographic characteristics and postoperative histological data from 1119 patients who underwent thyroidectomy in our center from January 2017 to January 2018. Variables of age, sex, and US features of thyroid nodule and lymph nodes features were analyzed. A logistic regression model was established for PTC prediction. RESULTS Logistic regression analysis confirmed that age under 45 years (OR=2.22, p=0.00), hypoechogenicity (OR=3.70, p=0.00), irregular shape (OR=2.13, p=0.004), ill-defined margin (OR=2.26, p=0.08), spiculate margin (OR=3.30, p=0.00), indefinite border (OR=2.45, p=0.00), capsular invasion (OR=7.76, p=0.006), taller-than-wide shape (OR=2.94, p=0.00), solid structure (OR=2.46, p=0.001), microcalcifications (OR=3.92, p=0.00), coexistence of microcalcifications and macrocalcifications (OR=5.84, p=0.006), and central vascularity (OR=2.10, p=0.001) were independently associated with increased risks for PTC, as well as lymph nodes metastasis features (absence of an echogenic hilum [OR=3.74, p=0.027] and increased vascularization [OR=3.55, p=0.086]). The area under the curve (AUC) for the risk score diagnosis system was 0.916. CONCLUSIONS This predictive model is a reliable, simple, and cost-effective diagnostic tool for PTC.