OBJECTIVE Percutaneous ethanol injection therapy (PEIT) has been used to treat various human neoplasms. We evaluated the local therapeutic effect of PEIT in recurrent thyroid cancers. METHODS From October 2002 to September 2005, we performed ultrasound-guided PEIT on 24 recurrent lesions (eight in thyroid beds and 16 in neck nodes) of 16 papillary thyroid carcinoma patients. Ethanol was injected at 3-month intervals under sonographic guidance. RESULTS All patients tolerated PEIT well with only mild local pain, although one patient complained of transient hoarseness after the procedure. The median diameter of lesions was significantly reduced, from 9.9 mm (range, 5.5-25.0 mm) to 5.3 mm (range, 0.0-17.0 mm) by PEIT. Four recurrent lesions disappeared sonographically. CONCLUSIONS PEIT may be an alternative treatment option for locally recurrent thyroid carcinomas in properly selected patients. However, a prospective, long-term follow-up study is necessary to determine the effect of PEIT on patient survival and tumor recurrence.