We report 39 cases of congenital cervical cysts removed operatively during a 20 year period in our clinic. The average age was 37.9 years old. (males: 33 years old, females: 44.3 years old) There were 22 males and 17 females. Ten cases (25.0%) were less than ten years old. The main symptoms were a cystic mass. Only 2 cases had a fistula. Signs of infection were found in 12 cases (30.8%). Simple excision of thyroglossal duct cysts was carried out in 10 cases without recurrence and 1 of the 29 cases who underwent radical excision (Sistrunk's procedure) recurred. To avoid recurrence, exact knowledge of anatomy as well as the correct preoperative diagnosis and adequate operative procedure are mandatory. Surgical excision of the central portion of the hyoid bone together with the fibrous tract extending to the base of tongue seems to be not warranted in some case, so long as complete eradication of the epithelial tissue can be made.