Background: Thyroglossal ductal anomalies classically manifest as painless midline anterior neck swelling. Diagnosis is usually based on clinical presentation. Objective: The aim of present study is to review cases diagnosed with thyroglossal ductal anomalies and the subsequent approach to management. Methods: The medical records of patients diagnosed with thyroglossal duct cysts and fistula from January 2001 till June 2016 were retrospectively analysed. Results: A total of 43 patients were included of which 28 were males and 15 were females accounting for male to female ratio of 1.9:1. The age ranged from 4 days to 15 years. Twenty three cases (53.48%) presented with discharging thyroglossal fistula while twenty cases(46.51%) as a painless cystic neck swelling. The most common site of the cyst was infrahyoid in 25 cases (58.14%). Conclusion: Thyroglossal ductal anomalies should be diagnosed and managed surgicall yearly to prevent fistula formationand recurrence. Sistrunk operation is the surgery of choice at our centre.