Most head and neck cancers are squamous cell carcinomas that arise in the epithelial layer of the mucous membrane which lines the upper aerodigestive tract. The most significant risk factors associated with the pathogenesis of these cancers are tobacco and alcohol consumption. Head and neck cancers have a tendency to metastasise to cervical lymph nodes. It is known that the status of lymph nodes along with size, localisation and extranodal spread is the most important prognostic factor. The presence of lymph node metastases significantly decreases patient survival rates. The treatment of metastastatic lymph nodes is based on the patterns of metastases, which are common depending on the primary site of cancer. This paper provides a review of neck dissections, surgical procedures in the treatment of metastasis in head and neck carcinoma. Radical neck dissection, which refers to the removal of all ipsilateral cervical lymph node levels including the sternocleidomastoid muscle, spinal accessory nerve and internal jugular vein, has been the gold standard of neck nodal treatment for a long time. Over the last few decades, several less radical procedures that retain certain lymphatic or non-lymphatic structures have been developed. Today, radical dissection of the neck is performed in a small number of cases, while most have been replaced by modified radical or selective neck dissection due to a reduced morbidity and equal oncological results.