Objectives: American Thyroid Association (ATA) practice guideline defines the intermediate-risk of papillary thyroid carcinoma (PTC) according to several pathological findings, of which prognostic impact has not been clearly determined. Therefore, we evaluated the clinical outcomes of intermediate- risk PTC and find risk factors of post-treatment outcomes. Methods:This study examined patients who underwent primary thyroidectomy and neck dissection for previously untreated PTC between 2006 and 2015 at our tertiary referral center. Intermediate-risk PTC was defined as having one or more of aggressive pathology, minor extrathyroid extension, lymphovascular invasion, or >5 involved lymph nodes (LNs) of 0.2 to 3 cm size according to the ATA guideline. Tumor multifocality and radioactive iodine avid neck lesions were also identified. Univariate and multivariate Cox proportional hazard regression analyses were used to define significant factors predictive of recurrent-free survival (RFS). Result:: A total of 1191 patients were classified as intermediate-risk group. Patients with intermediate-risk PTC were related to fairly good survival outcomes showing as much as the 5-year overall survival rate of 99.9% and the 5-year RFS rate of 97.5%. Of risk factors, tumor multifocality, extrathyroidal extension, and >5 involved LNs were significantly associated with poor RFS outcomes (all P <0.05). When adjusted with clinical and pathological factors, >5 involved LNs remained the significant factors predictive of RFS outcomes (P <0.01). Conclusion:Intermediate-risk PTC is associated with fairly good survival outcomes. Of risk factors, only >5 involved LNs may predict the post-treatment recurrence of intermediate-risk PTC.