Abstract Background Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid carcinoma. It has an excellent prognosis, with a 10-year survival rate of more than 95 per cent, although outcome is poorer for aggressive subtypes. Aim of the Work Our work in this study shows that the incidence of recurrence post hemi thyroidectomy is significantly higher compared to post total thyroidectomy and in case of multifocal and insular carcinoma with hemi thyroidectomy it increases the incidence of recurrence and drastically affecting the 10-year survival rate and the quality of life. Material and Methods We followed the PRISMA statement guideline during this systematic review and meta-analysis preparation and performed all steps according to the Cochrane handbook of systematic reviews of intervention. We searched PubMed, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, Embase, and Science Direct till November 2021 relevant keywords. We used the following search strategy for searching different databases: (“Papillary Thyroid Cancer” OR “Papillary Thyroid Cancers” OR “Papillary Thyroid Carcinomas” OR “Papillary Carcinoma Of Thyroid” OR “Papillary Thyroid Carcinoma” OR “Familial Non medullary Thyroid Cancer” OR “Non medullary Thyroid Carcinoma” OR “Non medullary Thyroid Carcinomas” OR “Thyroid Carcinoma, Non medullary” OR “Thyroid Carcinomas, Non medullary”) AND (Hemithyroidectomy OR Thyroidectomy OR Thyroidectomies OR thyroid removal). All the references of the included studies were searched for relevant studies. Results Multifocality and insular carcinoma and bilaterality increase the incidence of recurrence drastically so it is recommended for total thyroidectomy. Gender plays a role in the aggressiveness of the tumor but not in the incidence of recurrence as this is determined by the selection criteria of the candidate and the surgical technique. We studied 7 risk factors through this meta-analysis and it is recommended for application of LNR as a post op prognostic tool for recurrence and to apply hemi thyroidectomy for tumor size <2 cm instead of < 4 also meticulous pre-operative workup, accurate risk assessment, stratification and staging this is to customize a road map for every patient through a multi-disciplinary team. Conclusion In this meta-analysis we found that in low grade differentiated papillary thyroid carcinoma the recurrence is higher with hemithyroidectomy than in total thyroidectomy after applying the ATA guidelines for 10 years retrospectively but in case of 10 year survival it showed no significant difference.