Background & Aim: One of the commonest complaints of patients referred to ENT clinics is neck mass that accounts for 10-15% of the patients. However, thyroglossal duct cyst is the commonest congenital neck mass and the second common childhood neck mass that is usually presented before 5 years of age, but it sometimes remains asymptomatic until adolescence. Except lymphadenopathy, it is the commonest non-cancerous neck mass and should be differentiated from other neck masses. The fact that incomplete or incorrect treatment may lead to recurrence and difficulty in next attempts displays the necessity of knowledge and awareness on the part of physicians to decrease the rate of recurrence and complications by adopting a correct surgical approach. The present study was carried out to determine different clinical manifestations of the above-mentioned cyst and their incidence rates among Iranians to help doctors diagnose and treat the cases properly. Patients & Method: In this study we investigated files of patients who were admitted to Hazrat-e-Rasoul Akram and Firouzgar hospitals between 1991 and 2002 with the diagnosis of thyroglossal duct cyst confirmed by histopathological reports. Results: 54 patients including 53% male and 47% female participated in the study. The average age for males and females was 21 and 17.7 respectively. Major complaints consisted of neck mass(67.7%), discharge from anterior cervical region(29.5%), local abscess(3.5%), and lingual mass(2.3%). Regarding the location of the mass or fistula, 42 cases(82.3%) presented in midline cervical area, 3 cases(5.8%) in right cervical area, 5 cases(9.8%) in left cervical area, and one case(1.9%) intralingual. Concerning mobility, 31 cases(60.7%) presented with mobile masses or fistulas, 15 cases(29.5%) with immobile ones and in other cases required data was not available. Conclusion: Although the patients of the present study were reported to be older than those of similar studies, other signs and symptoms were the same.