Objective To summarize the research progress on diagnostic criteria of lymph node metastasis in medullary thyroid carcinoma (MTC), and the indication and scope of lateral cervical lymph node dissection (LCLND). Method By searching PubMed and CNKI databases, the related guidelines and literature about the diagnosis and treatment of lateral cervical lymph node metastasis in MTC in recent years were obtained and reviewed. Results The metastatic rate of lateral cervical lymph nodes in MTC patients was high. The indication of LCLND was both consensus and controversy. The LCLND of MTC was also controversial, and the focus of controversy mainly focused on the survival rate, recurrence rate, distant metastasis and postoperative complications of patients receiving prophylactic LCLND. Different imaging methods had their own advantages and disadvantages in diagnosing lymph node metastasis of MTC. Nuclear medicine was effective but expensive. Fine needle puncture was also an effective method for the diagnosis of lymph node metastasis of MTC. At present, calcitonin level, tumor size and lymph node metastasis were still important indicators for evaluating MTC for prophylactic LCLND, but the application of related indications had not been unified. Many scholars recommended comprehensive consideration of various indicators to evaluate whether MTC carried out preventive LCLND. Conclusions The LCLND of MTC needs to be further explored and standardized on the basis of the existing consensus. The focus of prophylactic LCLND should be to improve the survival rate of patients while reducing complications as much as possible.