A cervical mass should be approached in a systematic manner with a full knowledge of the possible etiologies and their consequences. The approach taken with a child differs markedly from that taken with an adult. Cervical masses in children are likely to be congenital or inflammatory. In adults, neoplastic masses are most common; most of these are metastatic. Indirect laryngoscopy, important in the search for the primary lesion, should be performed on all patients.