The thyroglossal cyst is a wellknown cause of a swelling in the neck. The generally accepted technique of treatment was described in 1928, but many recurrences are still seen in daily clinical practice. The radical technique of removal of cysts and sinuses of the thyroglossal duct according to Sistrunk is the method of choice. Over an 8-year period 40 cases were treated in this fashion in the University Hospital Groningen, the Netherlands, with an average follow-up of 5 years and 3 months; in 29 it was the first operation. Only 1 patient of the 23 treated according to Sistrunk had a recurrence for which he had to be treated again. Six patients were treated otherwise; 3 of them had a recurrence. It is concluded that the first surgery (according to Sistrunk), if correctly performed, offers the best chance for cure.