Metastatic cervical lymphadenopathy is a common problem in head and neck oncology. The appropriate management of the cervical lymph nodes requires a good understanding of the incidence, patterns, and prognostic implications of nodal metastasis. This paper correlates the anatomical and the simplified level classification systems of cervical lymph nodes, examines the clinical significance of nodal metastasis, and evaluates the criteria for nodal metastasis.