Correct diagnosis of a lesion or a condition is of utmost importance for proper treatment planning and its appropriate management. A multitude of pathologies may affect the head and neck region and may have multiple ways of presentation. Some of these may have significant pathognomonic signs and symptoms and may ease the diagnosis whereas some lesions might have overlapping signs and symptoms which may lead the clinician or the surgeon in the wrong direction. Following a systematic approach including the clinical diagnosis, radiographic aids, histopathological analysis and the use of advanced diagnostic modalities as and when required, is thus, the key to accurate diagnosis and its subsequent appropriate management.