Abstract:【Objective】To investigate the retropharyngeal lymph node metastasis and its clinical characteristics in patients with hypopharyngeal carcinoma. 【Methods】A total of 136 patients with hypopharyngeal cancer treated in our hospital were analyzed retrospectively. The TNM stage and clinical focus distribution of all patients with hypopharyngeal cancer were counted. According to the metastasis of retropharyngeal lymph nodes, the patients were divided into retropharyngeal lymph node positive group and retropharyngeal lymph node negative group. The clinical characteristics, postoperative regional recurrence and survival rate of the two groups were compared.【Results】Among 136 patients with hypopharyngeal carcinoma, 26 patients had lymph node metastasis (the metastasis group), accounting for 19.12%; and 110 patients had no lymph node metastasis (non metastasis group), accounting for 80.88%. There was no significant difference between the metastatic group and the non metastatic group in men patients with age ≥60, smoking, postoperative chemotherapy, hyperlipidemia and diabetes (P>0.05). The proportions of stage Ⅲ+Ⅳ, medium/high differentiation and distant metastasis in the metastasis group were higher than those in the non metastasis group (P<0.05). Stage Ⅲ+Ⅳ, medium/high differentiation and distant metastasis were the risk factors of lymph node metastasis in the metastasis group (OR=2.052, 3.536, 3.881, P<0.05). 【Conclusion】 The rate of lymph node metastasis is 19.12% in patients with pharyngeal cancer. Stage Ⅲ+Ⅳ, medium/high differentiation and distant metastasis are the risk factors of lymph node metastasis in the metastasis group.