Background: Patients presenting to the outpatient department with a neck swelling is of common occurrence which can pose a diagnostic dilemma to the head and neck surgeon. Most of the patients are worried about the possibility of a cancer. Objective: to study clinical presentation of various neck swellings and their management. Methods: Our study is a prospective study conducted in the department of surgical oncology and department of ENT in Karnataka institute of medical sciences, hubballi from July 2019 to December 2021. All patients presenting with a swelling in the head and neck region were included in the study. In the study period of 30 months, a total of 135 patients were included in the study. Results: In our study, out of 135 patients, 25 had swelling in the anterior triangle of neck of which 12 had nodular goitre of thyroid, 11 had papillary carcinoma of thyroid, 1 had medullary carcinoma and 1 had follicular carcinoma of thyroid. Of the 110 patients who had swelling in the posterior triangle of the neck, 60 had reactive lymphadenitis, 24 were due to tubercular lymphadenitis and 18 patients had swelling due to metastatic neck deposits.