BACKGROUND By the introduction of cross-sectional imaging, a new dimension in evaluation of neck lesions has evolved. The main reason for head and neck imaging is to evaluate the true extent of disease to best determine surgical and therapeutic options. To find out the role of multidetector computed tomography in the evaluation of neck lesions with respect to localization and characterization of neck lesions, with respect to anatomical plane delineation, extension to adjacent structures and bony involvement. The objectives of this study were- 1) To localize and characterize neck lesions with respect to anatomical delineation, extension to adjacent structures and bony involvement. 2) To correlate the findings of MDCT with final diagnosis. MATERIALS AND METHODS Data will be collected from patients with neck lesions referred to Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry. RESULTS Out of 30 cases studied, 12 (40%) were of benign aetiology and 18 (60%) were of malignant aetiology. Most of the patients were below the age group of 40 years except for a case of thyroglossal cyst in a 42-year-old male patient. Most of the malignant lesions of the head and neck region in this series including maxillary space carcinomas and pharyngeal mucosal space carcinomas, visceral space carcinomas and metastatic lymph nodes were above the age of 45 years except for 4 cases. CONCLUSION From this study, we conclude that, Multidetector Computed Tomography of the neck has improved the localization and characterization of neck lesions. The most important advantage lies in its ability to detect bony lesions.