Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid malignant neoplasm. PTCs measuring 1 cm or less were defined by the World Health Organization (WHO) as papillary thyroid microcarcinoma (PTMC). Thermal ablation stands as a therapeutic modality encompassing microwave ablation (MWA), laser ablation (LA), and radiofrequency ablation (RFA). Its effectiveness and safety have been subject to evaluation in the management of benign thyroid nodules and recurrent PTC. Nevertheless, the utilization of thermal ablation as a therapeutic intervention for low-risk PTMCs has sparked controversy and lacks endorsement in the guidelines delineated by the National Comprehensive Cancer Network (NCCN) for thyroid carcinoma and the American Thyroid Association (ATA). RFA stands as a viable, safe, and effective treatment for selected patients with PTMC. Along with active surveillance (AS), it may represent an alternative for patients who refuse surgery or have risks that contraindicate surgery. Pre-procedure, procedure, and post-procedure follow-up are important for a successful procedure.