The cervical lymph nodes are important immune organs in the body. Due to their superficial location, enlargement is easily detected at an early stage and can be both a more common clinical condition and a sign of a disease. Infections, tuberculosis, lymphoma and cancer metastases can cause enlargement of lymph nodes in the neck, and their qualitative diagnosis is clinically important in determining treatment options. Chronic lymphadenopathy of the neck often presents as a painless or slightly painful mass with a medium texture, clear and mobile borders, and patients may have a history of oral or pharyngeal infections. In recent years, there has been a global trend towards the rise of tuberculosis. Cervical lymph node tuberculosis is the most common form of extrapulmonary lymphatic tuberculosis, and its incidence has been increasing in recent years, accounting for about 81% of extrapulmonary tuberculosis. In recent years, cervical lymph node tuberculosis has become a common disease of the neck, and most patients have no history of tuberculosis and no symptoms of tuberculosis poisoning in the early stage. The lymph nodes can be large or small, larger than 6 cm and smaller than 2 cm; they can be single or multiple; they can be mobile or adherent; they are hard, but a few of them can be soft, and after softening, the lymph nodes can be seen as patchy low-density shadow in the center of CT scan, which is often misdiagnosed. However, surgical management of lymph node tuberculosis still has an important status, and such patients should be treated with regular anti-tuberculosis therapy after surgery. Since malignant tumors of the head and neck, chest and abdomen can metastasize to the lymph nodes of the neck, so metastatic cancer in the neck and the location of the primary cancer can spread throughout the body, and such enlarged lymph nodes do not have specific manifestations, pathological histological examination of lymph nodes is the only means to finally confirm the diagnosis of metastatic cancer in lymph nodes, especially the widespread application of immunohistochemistry, which can more accurately determine the histological type of metastatic cancer and differentiate it from lymphoma and mesenchymal tissue sarcoma. The recent view on its treatment is that reasonable treatment should be selected according to the site of metastasis, stage of lymph node enlargement and pathological type, which mainly includes radiotherapy, surgery, chemotherapy and the combination of two or three of them. Malignant lymphoma can occur in a variety of tissues and organs throughout the body, but most of them originate in lymphatic tissues or lymph nodes, especially in the cervical lymph nodes. Malignant lymphoma can be divided into intra-nodal and extra-nodal types, and those occurring in the neck are mostly intra-nodal. The enlarged lymph nodes can be mobile in the early stage, with normal skin surface, firm and elastic texture, relatively full, no pressure pain, and varying size. Other rare diseases of the neck, such as cat-scratch disease (CSD), are diagnosed by: enlarged lymph nodes; history of cat contact or scratching; skin test (+) for cat-scratch antigen; and typical histopathological changes. The diagnosis was established with three of the above four items. The incidence of cat-scratch disease has increased in recent years as people’s standard of living has improved and more people keep cats, dogs and other pets, and clinicians should be alert to this. Nodular disease is a chronic granulomatous lesion occurring in multiple systems and tissues throughout the body, and it is generally believed that cellular and humoral immune dysfunction is its pathogenesis. The possibility of lymph node disease should be considered. The prognosis is better after simple surgical excision of solitary cases. In summary, the causes of enlarged lymph nodes in the neck are complex, so clinicians should take a detailed medical history and careful physical examination according to the clinical features of enlarged lymph nodes in the neck, and perform lymph node excision and biopsy if the diagnosis is difficult to be confirmed by auxiliary examination, so as to clarify the diagnosis and guide clinical treatment.