One of the more common cervical lesions seen in children is cervical lymphadenitis. Pediatricians handle the vast majority of these children who present with an acute infection. The pediatric surgeon becomes involved only when the presumptive infection does not respond to antibiotic therapy, or if the lump becomes chronic and persists for weeks or months. In this situation the specter of malignancy looms, but benign causes still predominate. The infectious agents range from common bacteria such as staphylococci and hematologic staphylococci to atypical mycobacterium, fungi, and other much less common organisms. A broad discussion of the numerous causes of cervical lymphadenitis is presented together with a pragmatic diagnostic and therapeutic approach.