While histopathology remains the gold standard for tissue diagnosis, several new diagnostic techniques are being developed that rely on physical and biochemical changes that mirror or precede malignant change within tissue. The aim of this study was to compare findings of elastic scattering spectroscopy (ESS) with histopathology on formalin fixed neck dissection specimens to see if this technique could be used as an adjunct or alternative to histopathology in defining nodal involvement. The technique involves the use of Mie scattering and is a simple non-invasive method of tissue interrogation. One hundred and thirty lymph nodes were examined from 13 patients who underwent neck dissection. The nodes were formalin fixed, bivalved and examined by ESS using a pulsed xenon lamp. The intensity of the spectrum at 4 points was considered for comparison; at 360, 450, 630 and 690 nm. The nodes were then routinely processed and haematoxylin and eosin-stained sections examined histopathologically, and the results compared. Using this technique, a sensitivity of 98% and a specificity of 68% were obtained.