Neck nodes always have been evaluated by physical examination .and because the fingers are not sensitive probes for small nodes a substantial false negative rate as high as 70%may be anticipated. Because of that we tried to assess lymph nodes by comparing computerized tomography , ultrasound and ultrasound guided FNAC. We studied 100 patient with head and neck cancer. We found that U/S guided FNAC is the most specific (100%) ,highly sensitive (90.9%) and most accurate (96.1%)So U/S guided FNAC may change the indication of elective neck treatment and reduces the number of un necessary neck treatment.