This study was conducted to see whether the hilar echogenicity alone is a good criteria for detection of cervical lymph node metastasis in patients with oral squamous cell carcinoma(OSCC). MATERIALS AND METHODS: Twenty patients with OSCC (14 males and 6 females) , their age 40-90 years , were examined sonographically, and the number of cervical lymph nodes studied was 112. Hilar echogenicity alone was used as a criteria to differentiate between benign and malignant cervical lymph nodes. Lymph nodes were evaluated for their echogenic hilus, number, size, site, shape , as well as for necrosis. The results of US evaluation were compared with histopathologic outcome using unpaired t-test and Fisher's exact probability test. RESULTS: Ultrasound examination yielded a sensitivity as 84.09%, specificity 95.59%, accuracy 91.07%, positive predictive value (PPV) 92.5% , and negative predictive value (NPV) 90.28%. CONCLUSIONS. Sonographic examination have a high accuracy in detecting cervical lymph node metastasis in patients with oral squamous cell carcinoma, depending on hilar echogenicity as a diagnostic criteria .