Every day, many parents come to surgery with swollen lymph nodes in their child’s neck and ask if it is important. In children, the lymphatic system is well-developed and the lymph nodes in the neck are more distributed, which are easily palpable because of their superficial location. After puberty, as they grow older, the lymph nodes gradually shrink and become difficult to palpate. In normal children, there are mostly palpable lymph nodes in the neck, varying in number, the size of a soybean, movable, and without pressure pain. If the child has no fever, sore throat or other symptoms of infection, he or she can be followed up on an outpatient basis. If the child has a recent cold, laryngitis, tonsillitis or other acute or chronic infectious diseases, swollen lymph nodes in the neck, painful to touch, or even pus in the lymph nodes may occur and require anti-infective treatment. If the tonsils are enlarged to a third degree or if they are septic, the patient will have to go to the quinturology department for consultation on whether to have the tonsils removed. Another concern for parents is whether the enlarged lymph nodes can become malignant, i.e., develop lymphoma or leukemia. The incidence of this malignant lymphatic or hematologic disease is low and is more common in older children (>10 years of age). It mostly presents clinically as a painless mass that easily fuses into a mass and grows rapidly. Children often have anemia, weakness, and loss of appetite. Blood tests may be normal or may reveal naïve cells. Definitive diagnosis requires a puncture or biopsy of the mass. Given the malignant potential of enlarged lymph nodes, parents are advised to be more observant and seek medical attention promptly.