Abstract Our experience with this small series of patients with penetrating wounds of the neck parallels that of several other groups and supports the dictum that all such wounds should have prompt exploration. More than half will have injury to a major structure and yet one third will not manifest such an injury. The morbidity and mortality of a neck exploration in which the findings are negative is minimal and the potential for correction of a significant injury is great. Preoperative evaluation must be complete if therapeutic difficulties are to be avoided. Finally, since any of the major structures of the neck might be damaged, the surgeon must be familiar with the principles of therapy for injury to each vital structure.