1st branchial cleft anomaly is different from 2nd & 3rd branchial cleft anomaly developmentally, clinically and histopathologically because it is due to some part of duplication anomaly of 1st branchial cleft but 2nd or 3rd branchial cleft anomaly is due to failure in obliteration of cervical sinus of His. Diagnosis and treatment of 1st branchial cleft anomaly depends on clinician's experience and decision according to clinical findings. We evaluated 7 cases of 1st branchial cleft anomaly(5 cases of type I and 2 cases of type II) to obtain more available clinical and histopathologic findings. We concluded that a mass, cyst or tract around parotid gland and multiple incision and drainage in prepubertal-aged patient should be considered as 1st branchial cleft anomaly rather than other disease.