Background: Cutaneous head and neck swellings present clinically with enormous and variable lesions and they represent different dermatoses. Therefore, establishing an accurate diagnosis forms a challenge to physicians and a concern to pathologists. Certain clinical clues may aid in reaching the diagnosis, however, histopathological examination is an additive diagnostic tool in certain instances. Aim of work: The aim of this study is to perform a clinicopathological assessment of all cutaneous head and neck swellings over a period of six months and consequently identifying the clinical spectrum of head and neck swellings in Egypt.Patients and methods: A prospective cross sectional study was planned in which for a period of six months, all patients with cutaneous head and or neck swellings were the subjects of the study. The study was performed during the period from March - September 2012. During this time period, patients who fulfilled the positive criteria were one hundred and five patients and they were subjected to complete medical history, general examination, detailed assessment of cutaneous swellings as well as laboratory investigations as needed. Accordingly, a provisional clinical diagnosis or a clinical differential diagnosis was suggested by the principal investigators. Skin biopsies were examined histopathologically and the final diagnosis was established based on clinicopathological correlation. Results: The current study included 105 patients, 59 males (56.2%) and 46 females (43.8 %). Ages ranged from 0.16 – 79 years with a mean of 37.99 years ± 18.50. Histopathological evaluation and clinicopathological correlation revealed the following spectrum of disorders: Epidermal tumors and proliferations in 26 patients (24.8%), cysts in 13 patients (12.4%), adnexal neoplasms in 16 patients (15.2%), melanocytic neoplasms in 19 patients (18.09%), vascular proliferations and neoplasms in 7 patients (6.7%), neural neoplasms in 2 patients (1.9%), fibrous and fibrohistiocytic proliferations and neoplasms in 3 patients (2.9%), cutaneous lymphoid infiltrate in 2 patients (1.9%), cutaneous non-lymphoid infiltrate in 9 patients (8.6%), infections in 3 patients (2.9%) and 5 patients (4.8%) had miscellaneous diagnoses. Non neoplastic lesions constituted 31.4% (33 patients) and neoplastic 68.6% (72 patients). Benign neoplasms represented 50.5% (53 patients) of the studied group and malignant neoplasms 18.1% (19 patients). Clinical diagnoses of observer A were matched with the final diagnosis, established by the clinicopathological correlation, in 85 cases (81%) and mismatched in 20 cases (19%), whereas those of observer B were matched with the final diagnosis in 81 cases (77.1%) and mismatched in 24 cases (22.9%). There was an inter-observer variation in the provisional clinical diagnosis in 20 patients (19%), (Kappa value=0.353 and P=0.000).Conclusion: Based on the difficulty of clinical differentiation between the cutaneous swellings of the head and neck and its significance in diagnosis and prognosis, it is of prime importance to perform histopathological identification to reach an accurate diagnosis.