This study seeks to establish whether CT can accurately detect cancer in cervical lymph nodes. Retrospective correlation of CT scans and surgical findings in 51 patients with laryngeal cancer undergoing radical neck dissection suggested that the node-bearing areas in the neck can be usefully evaluated with CT scans. An additional 10 patients studied prospectively with carefully correlated CT scans and radical neck dissections were used to evaluate CT specific criteria for cancer in individual nodes. In 13 patients CT correctly predicted surgically confirmed nonpalpable nodal metastases in six. It suggested false-positive nodes in two. These criteria are now being tested in an ongoing evaluation of the clinical value of CT in the management of head and neck tumors.