Objectives: To study the pattern of cervical lymph node metastasis in cases of upper aero digestive tract malignancies and to determine the distribution of primary site in upper aero digestive tract in cases of cervical lymph node metastasis. Materials and Methods: The patient presented with neck swelling either clinically or detected during evaluation of neck in malignancies of upper aero digestive tract was enrolled in the study. Patient data collected included age, sex, detailed history regarding primary lesion and occurrence of neck swelling. Tumor characteristics evaluated included tumor site, size, histopathological grade and pattern of neck metastasis and TNM classification by clinical examination and relevant investigations. Results: Regional metastases were more common from tongue, supraglottis, pyriform sinus than glottis, sub glottis and post cricoid tumors. Primary tumors of increased size, moderately and poorly differentiated tumor were at higher risk for nodal metastasis. Predominance of certain levels of lymph nodes is seen for each primary site, level I,II &III were at higher risk for metastasis in cases of oral cavity carcinoma and level II, III,&IV were at higher risk for metastasis from carcinoma of the oropharynx, hypopharynx and larynx. The most common site for metastasis detected were at levels II and III and majority of the cases presented at N2 stage. There is increased risk of upper aero digestive tract malignancies as age advances and more common in males. Most of the patient reported in advanced stage of disease. Interpretation and Conclusion: These findings confirm the predominance of certain levels of lymph node group for each primary site. Data on the pattern of neck node metastasis would then provide basis for advocating limited neck dissection for patients harboring different primary tumor with limited neck disease i.e. NO and N1. As the majority of the patients presented at the advanced stage of disease, there is a increased need to bring awareness to detect disease at very early stage.