Fine needle aspiration is a widely used diagnostic tool. Its use for the evaluation of head and neck masses remains somewhat controversial. This retrospective study analyses all patients presenting with neck masses investigated by fine needle aspiration in our institution from January 1997 to December 1998. 372 fine needle aspirations were performed. Cytological diagnosis was possible in 91%. Sensitivity was found to be 100%, specificity 99% and accuracy 99.7%. When including indeterminants in the false-negatives, overall sensitivity is 73%, overall specificity 100% and overall accuracy 90%. There were no complications, and in particular no suprainfection and no tumoural spread at the puncture site. We conclude that fine needle aspiration is a sensitive and specific modality which is very helpful in the diagnostic work-up of a neck mass