dissection has been performed as a primary management for the neck node metastasis in head and neck cancer, but controversy surrounds the elective neck dissection if neck node metastasis is not confirmed. The pathologic examination is the only definitive way for determining of actual involvement of regional lymph node, we analyzed 28 patients of squamous cell type of head and neck cancer to access the incidence of occult neck nodes through clinical and radiologic exminations by a comparison with pathological examination. The results were as follows : 1) Therapeutic neck dissection were done in 31sites(66%), elective neck dissection were 16sites(34%). 2) Differencies between combinations of palpable and radiologic and pathologic staging were sensitivity 84%. So we could confirm occult nodes in 15.3%. As a results, we suggest that elective neck dissection may increase the cure rates in high risk metastatic groups of head and neck cancer, even if involvements of lymph node were not confirmed in preoperative clinical study.