The aim of our study is to detect parameters which may predict recurrences during long-term follow-up in papillary thyroid cancer patients who achieved remission after primary treatment. The data of 492 patients who achieved selected remission criteria after primary treatment were recorded. Remission criteria were for anti-thyroglobulin (antiTg)-negative patients: no uptake in first iodine-131 whole body scan (WBS) after primary treatment and stimulated thyroglobulin (Tg) level <2 ng/ml when TSH >30 μU/ml. Recurrence was detected in 12 of 492 patients (2.4%). Tumor size, stimulated Tg concentrations and frequency of antiTg positivity at first WBS and duration of follow up were significantly higher in patients with recurrence compared with remaining patients (P: 0.024, 0.013, 0.01, 0.002 respectively). Patients with stimulated Tg≥0.25 ng/ml at first WBS had significantly higher frequency of recurrence compared with patients having Tg<0.25 (P: 0.009). Cox regression and Kaplan-Meier survival analyses indicated that lymph node metastasis at initial presentation was the only parameter significantly related to recurrences during follow-up (P: 0.011, 0.01 respectively). We conclude that patients with lymph node metastases at presentation and relatively higher (>0.25 ng/ml) Tg and anti-Tg positivity at first WBS have higher risk for recurrence.