Lingual thyroglossal duct cysts are a form of thyroglossal cysts, and account for 1%-2% of thyroglossal duct cyst which have a unique presentations with regard to age and locations. Definitive treatment is complete surgical excision, but major difficulty of management in lingual thyroglossal duct cyst is the recurrence after inadequate surgical excision. Therefore, several surgical approaches have been introduced but still controversial. Authors experienced three patients with midline cystic mass of tongue base, and we performed two surgical approaches as follows. Suprahyoid pharyngotomy approach was carried out for one case and intraoral approach using KTP-532 laser for two other cases. One case among the latter recurred after a year has been reoperated by the suprahyoid pharyngotomy approach. All the patients are well on, at 2 years follow up after the surgical excision.