Background and Objective: To describe the clinical presentation, surgical intervention and treatment, complications, tumour histopathology characteristics, follow-up and survival of 23 patients at or below the age of 21 at the time of diagnosis of differentiated thyroid carcinoma (DTC) diagnosis. Materials and Methods: A retrospective medical chart review of 23 patients diagnosed with DTC and treated in our institute from January 2003 to December 2013 was done. Pertinent data were collected regarding clinical presentation, workups, surgical intervention and treatment, postoperative complications, histopathology, follow-up events and survival. Results: The median age at diagnosis was 17 years. 15 patients (65.2%) had papillary carcinoma and 7 patients (30.4%) had papillary carcinoma with follicular variant. Multifocality and extrathyroidal extension were found in 11 (47.8%) and 6 (26.1%) patients respectively. 21 patients underwent total thyroidectomy with neck dissection and were subjected to thyroid ablation with radioactive iodine (radioiodine) and thyroid stimulation hormone (TSH)-suppressant thyroxine replacement therapy. Median follow-up was 6.6 years. Recurrence occurred in 1 patient. No significant postoperative complications were observed. Conclusion: Appropriate investigations should be carried out to exclude thyroid cancer in children and adolescents presenting with a neck mass. Total thyroidectomy with appropriate cervical lymph node dissection, followed by radioiodine ablation therapy and TSH-suppressant thyroxine replacement therapy is the recommended option to manage children and adolescents with DTC. Neck examination should be part of the routine clinical examination in the paediatric and adolescent age group. A local elaborate genetic database for this disease is essential and may help compare its behaviour with that seen in other populations.