High-resolution ultrasound is widely used imaging modality to evaluate the morphology, internal architecture, size and shape of cervical lymph nodes. In the head and neck, the image guidance technique most commonly used has been ultrasound. The real-time capability and ease of use makes ultrasound the procedure of choice. The evidence of improved efficacy of ultrasound-guided FNA over palpation-guided FNA in the head and neck also has been well documented, leading to its acceptance as the standard procedure.