Branchial Cleft Cysts are congenital cysts, that arise in the lateral aspect of the neck when the second branchial cleft fails to close during embryonic development. These arches and clefts contribute to the formation of various structures of the head and neck. Branchial cleft cysts are the most common of congenital neck masses. They are bilateral in about 2-3% of the cases. Usually, they do not appear at birth, but become noticeable much later in life. If they get infected, they may form a deep neck abscess or a draining fistula. The treatment of branchial cleft cysts is surgical excision.