Infections of fascial spaces of the neck continue to be life-threatening events. The frequency of these infections has been drastically reduced by antibiotics and good dental care. Intravenous drug use and immunosuppressed states have altered the modern presentation of these infections. This paper represents a review of these conditions, the anatomical and microbiological factors involved and the treatment. Attention is given to the use of modern imaging and contemporary antibiotic management. A clear understanding of regional anatomy remains critical to the proper resolution of these conditions.