Identification of a patient with regional neck node metastasis and treating them accordingly is very important so as to reduce the mortality associated with head and neck malignancies. The study was conducted in a tertiary care center in Maharashtra. Determination of neck node metastasis is important in cancer bearing patients especially when it comes to deciding the further line of management and also is of prognostic significance. The aim of this study was to correlate the evidence of neck node metastasis on both clinical as well as histopathological examination. The most common tumour and nodal staging at presentation were also found out Methodology: A proforma was filled out for each patient with head and neck malignancy from the medical registry that has underwent any type of neck dissection along with resection of primary tumour. Results: The sensitivity and specificity of clinical examination for neck node metastases was found to be 70.59% and 60.61% respectively. The positive and negative predictive values for the same is 48% and 80% respectively. Most of the patients presented with a tumor stage of T2 but when it came to nodal staging alone, 50% of the patients did not have any clinically palpable cervical lymph nodes. Conclusion: The study showed how important is it do address the neck electively in a case of head and neck malignancy along with resection of primary tumor as even in cases where neck nodes were not palpable clinically there was evidence of neck node metastasis on histopathological examination.