Pediatric surgeons frequently encounter cervical masses with intriguing clinical presentations in infants and children. Some can be easily diagnosed with a good history and physical examination, such as the thyroglossal cyst. Others require more extensive investigation and imaging to accurately diagnose and treat. The vast majority are benign in origin; however, rarely, they can be malignant.1 They frequently form from residual embryologic structures that have failed to resorb completely, or failed to mature. Knowledge of the embryological origins of these cysts and sinuses, along with a detailed knowledge of neck anatomy, is essential for proper management and for successful dissection and excision. Thyroglossal duct cysts are the most congenital neck masses to be encountered in practice, followed by branchial cleft anomalies and dermoid cysts.2 We will discuss in this chapter the embryology of the neck, followed by a brief review of the common neck cysts and sinuses, along with their management.