INTRODUCTIONThe term lymphadenopathy refers to nodes that are abnormal in size, shape, consistency or number.1 Cervical lymphadenopathy is one of the commonest presentations of underlying pathology of the head and neck region which has large number of differential diagnosis like neoplasms, infections (specific and non-specific), in immune deficiency disorders and also in rare disorders like inflammatory pseudotumour (plasma cell granuloma) and Kikuchi-Fujimoto disease. Various diagnostic modalities like fine needle aspiration cytology, ultrasonography (USG), computerized tomography and PET CT neck are now available to diagnose underlying disease in cervical lymphadenitis. These investigating tools have high sensitivity and specificity for cervical lymphadenopathy. The standard modality in the workup of a neck mass is fine needle aspiration (FNA). FNA can be used for both cytology and culture (in cases in which a suspected infectious neck mass does not respond to conventional antibiotic therapy). If FNA is unsuccessful or if sufficient information is not obtained from an initial FNA, the FNA should be repeated before open biopsy. 2Aetiology and clinical presentation of cervical lymphadenopathy is certainly different in different groups of population. Understanding prevalent conditions and ABSTRACT Background: Cervical lymphadenopathy is one of the commonest presentations of underlying pathology of the head and neck region which has large number of differential diagnosis like neoplasms, infections (specific and nonspecific), immune deficiency disorders and rare disorders like Inflammation. Pseudotumour (plasma cell granuloma) and Kikuchi-Fujimoto disease. Methods: The present study is a prospective study conducted in our institution Dr B.A.M. Central Railway Hospital, Mumbai. Our study included 115 patients with cervical lymphadenopathy presenting with swelling of more than 1.5 cm size in longest diameter. All the patients included in our study are more than 12 years of age, in whom the lymph node did not regress after adequate antibiotic therapy in acute cases (i.e. Conservative management for at least 2 week), and all the chronic cervical lymphadenopathy patients. Results: Tuberculosis was found to be the most common cause of cervical Lymphadenopathy in 54.78% cases followed by reactive lymphadenitis in 22.61% cases, chronic nonspecific lymphadenitis in 12.17% cases and metastatic lymphadenopathy in 7.83% cases. Other causes were unknown primary in 1.74% cases and non-Hodgkin's lymphoma in 0.87% cases. Sensitivity and specificity of FNAC was 79.36% and 100% respectively. Conclusions: Tuberculosis, reactive lymphadenitis and malignancy are the most important cause of cervical Lymphadenopathy. They present in different age groups with different clinical feature. Fine Needle Aspiration Cytology (FNAC) is extremely sensitive and highly specific investigation for early diagnosis.