The differential diagnoses may be arranged categorically into congenital, inflammatory, and neoplastic lesions. Surgery plays a vital role in the diagnoses and management of virtually all congenital and neoplastic masses in the neck. Pathologically proven 240 cases of neck masses were analyzed during the period of 1991 at the department of Otolaryngology-Head and Neck Surgery, KCCH. The following was observed. Among 239 cases of neck mass, 13 cases (5.4%) were congenital, 41 cases (17.2%) were inflammatory, 56 cases (23.4%) were benign neoplasms, and 129 cases (54.0%) were malignant neoplasms. Congenital masses were the most frequent in the third decade, with the mean age at 27.0 years. Inflammatory masses were the most frequent in the fourth decade, with the mean age at 37.3 years. Benign neoplastic masses were the most frequent in the fifth decade, with the mean age 43.7 years. Malignant masses were the most frequent in the sixth decade, with the mean age 53.4 years. The clinician should be considered the possibility of malignant neoplasms when examed the patients of neck mass older than fifth decade.