A prospective study evaluating the benefits of preoperative ultrasonography of paediatric neck abscesses is presented. Twenty-three consecutive children who presented with suspected neck abscesses to the Accident and Emergency Department at the Temple Street Children's Hospital between 1990 and 1992 have been evaluated prospectively. On admission, ultrasonography showed a collection of pus in 11 children and these underwent incision and drainage. The other 12 had intravenous antibiotics. Six of these remained pyrexial and had a repeat ultrasound after 72 h revealing pus which was drained. The remaining were managed successfully with medical treatment. In this study there were no negative surgical interventions and we recommend ultrasonography for preoperative evaluation of children with suspected inflammatory neck abscesses.