The finding of a neck lump in a child is often of major concern to the parents, and a common ENT presentation. This chapter not only outlines the approach to the child with a neck lump, focusing on lymphadenopathy and salivary gland lesions but also provides a brief description of the various differential diagnoses. Diagnosis and management of a neck mass in a child depend on careful history-taking and detailed physical examination. The correct investigations will aid decision making and a management plan can then be recommended. It is important to consult other disciplines in children with malignancy or other complex presentations. Midline masses, thyroid nodules and thyroid cancer, lateral masses, vascular anomalies, lymphatic malformations, rhabdomyosarcoma, neurofibroma, Lemierre’s syndrome, congenital muscular torticollis, salivary gland lesions, ranula, non-Hodgkin’s lymphoma, etc. are covered throughout this chapter.