Papillary thyroid cancer extends to lymphatic nodes in approximately 40% of cases. Node involvement often occurs in the internal jugular and recurrent laryngeal chain on the side of the lesion. To the authors' knowledge, only 4 cases with I-131 uptake in pharyngeal metastatic nodes have been reported previously in the literature. The authors report parapharyngeal node involvement demonstrated by I-131 scintigraphy in a patient with papillary thyroid cancer.