From 1983 to 1989, ninety-two in hospital cases of surgically treated thyroglossal duct cysts were reviewed. 4 patients (4%) were found to have metaplastic changes of the lining epithelium. Recurrence and the potential for malignancy are two main problems in the treatment of thyroglossal duct cyst. We advocate the Sistrunk procedure to be the choice of surgical treatment for thyroglossal duct cyst.