The neck masses have numerous origin, and especially malignant cases have wide organ involvement as primary site. Thus, systemic approach is essential in differentiating benign from malignant neck masses. A clinical analysis of 281 cases of the neck mass confirmed histopathological examination was done retrospectively during last 5 years. The results were followings ; 1) Of 281 cases, 72.2% was benign and 27.8% was malignancy. Inflammatory neck mass was most frequent(54.2%) among benign cases and most frequent malignancy was metastatic mass(74.4%). 2) Benign neck mass was frequent during age of third and fourth decades(54.7%), whereas malignancy was detected mostly among the patient over 50 years(75.6%). 3) 65% of benign and 56.4% of malignant mass was located at anterior triangle. 4) Size of 1-3cm was in 53.2% of benign mass and in malignant mass 74.4% had size of over 3cm. 5) As a primary site of metastatic neck mass, nasopharynx was most commonly detected(15.5%). For the cell type, squamous cell carcinoma was 60.3% of all metastatic cancer. 6) Benign mass were treated mainly at GS Dept., and malignancy were at ENT Dept. 7) Surgical extirpation was performed about 56.2% of benign mass and combination treatment of operation and radiotherapy was done about 25.7% of malignant mass.