The radical neck dissection specimens of 384 ethnically Chinese patients with different primary squamous carcinomas in the head and neck region were studied. Over 50 per cent of the specimens showed metastatic disease at one level in the neck. For oral cavity carcinoma, the levels of metastasis frequently involved were I, II and III while for carcinoma of the oropharynx, hypopharynx and larynx the levels were II, III and IV. Extracapsular spread was present in 112/384 of patients (29 per cent) and this increased with advancing N-stages. Based on these findings, different selective neck dissections could be used for patients harbouring different primary head and neck carcinomas with limited neck disease.