Thyroglossal duct cysts and branchial cleft anomalies are important in the differential diagnosis of cervical lesions. Both lesions are common and are seen more commonly in the child than in the adult. Considerable discomfort and morbidity may be associated with severe infections occurring in both of these lesions. Of importance is the observation that once these congenital cysts become infected, subsequent surgical removal is very difficult, and recurrence may result. For these reasons it is essential that the clinician become familiar with the embryology of these lesions, which is vital to the understanding of them. In addition, the development of skills in diagnosing and managing this condition is essential.