Congenital auriculocervical fistula is a rare occurance and reporting of the challeges in diagnosis andmanagement is not common. Ten cases of congenital first branchial fistula were reviewed. Of these, 8underwent fistulectomy with facial nerve dissection and partial parotidectomy and 2 underwent simplefistulectomy. The inner openings (upper opening) of fistulae lay in the following sites: inferioposterior wallat the junction of cartilaginous and bony segments of the auricular canal and inferior wall of cartilaginousauricular canal. The outer openings (lower opening) lay along the anterior border of uppersternocleidomastoid muscle, at the mastoid tip and posterior to the mandibular angle. Complete fistulaeresection was achieved in all but not one case. Eight cases were followed for 5 year with no recurrence.Recurrence occurred in 1 case 6 months after the primary surgery and revision surgery was performedConclusions Pre-operative radiography for the location and course of the fistula is crucial for successfulfistula resection, especially in cases with past infections. Facial nerve dissection should be done routinelyfor deeply located fistulae.