It is commonly believed that the branchial anomalies are remnants of the branchial apparatus. They present as a cyst, draining sinus or fistulous tract or any combination thereof. Their origin is thought to be from the branchial clefts with the second cleft most commonly involved. The sinus and/or fistula(e) are usually noted during infancy and young childhood due to recurrent infection. Cysts, however, require more time to produce palpable masses, and often are not diagnosed until later childhood. The first cleft fistula is found entirely above the hyoid bone with an external opening in the floor of the external auditory canal. The third cleft fistula dips behind the internal carotid artery to the pyriform sinus. The fourth and sixth cleft fistulae are only possible theoretically. We have recently experienced a case of branchial fistula and report this case with review of the literatures.