A thyroglossal duct cyst is a rare congenital anomaly resulting from retention of an epithelial tract between the thyroid and the foramen cecum linguae, and most often appears with a palpable asymptomatic midline neck mass in the pediatric age group. The fistula results from spontaneous rupture of cyst due to inflammation and inadequate excision. The authors have experienced 32 cases of thyroglossal duct cyst and fistula which were treated surgically in the Department of Otolaryngology, Chunan Hospital, College of Medicine, Soonchunhyang University from January 1985 to December 1989. The results were as follows ; 1) Age distribution was common under 20 years old in 22 cases(68.8%) and sex distribution was not significant. 2) Duration of onset was predilection under 1 year in 19 cases(59.4%). 3) Types were cysts 21 cases(65.6%) and fistulas 11 cases(34.4%), and 10 cases had the previous operated history. 4) Position of lesion was most common in the midline in 27 cases(84.4%). 5) Thyroglossal tracts passed below the hyoid in 18 cases(56.2%). 6) In microscopic examination, thyroid tissue was contained within the lesion in 5 cases(15.6%) and the most common lining epithelium was squamous in 21 cases(65.6%). 7) The lesion was connected to the thyroid gland in 1 case. 8) The entire cases were operated with Sistrunk procedure and 1 case recurred.