A retrospective study of malignant cervical lymph node enlargement of unknown origin was made from 1985-1995. Of 26 cases observed, the primary tumor was found in 8 cases after a complete ENT study in 3 the primary tumor was found in the course of the disease and in 15 the origin remained unknown. Patients were treated with a combination of surgery, chemotherapy and radiation therapy. Only 2 patients survive, one with 6.5 years of follow-up and the other with 20 months. The literature was reviewed for new diagnostic and therapeutic methods for cervical lymph node enlargement of unknown origin.