The retropharyngeal lymph nodes (RPLNs) are located in the retropharyngeal space, within a pad of adipose tissue. This fat pad and lymph nodes are located behind the posterior wall of the pharynx, anterior to the prevertebral fascia and the cervical sympathetic trunk and ganglion, and medial to the internal carotid artery. The RPLNs are divided into medial and lateral groups, and they receive lymphatic drainage from the nasopharynx, tonsil fossa, the walls of the oropharynx and the hypopharynx, and the posterior ethmoid sinuses. A RPLN dissection is indicated in the treatment of tumors of the tonsillar fossa, oropharyngeal, and hypopharyngeal wall. A detailed description on the surgical technique of RPLN has been presented in this chapter with the help of suitable diagrams.