Introduction: The first branchial cleft anomalies are a special group of congenital malformatons of head and neck. They are rare even among bronchiogenic anomalies and the incidence ranges among less than 1% to more than 25% of the branchial anomalies. Many theories were proposed to explain the appearance of the branchial anomalies, and the best one is that sugests it results of an incomplete involution of the branchial apparatus. Aim: The propose of this paper was to identify the forms of anatomical and clinical presentation of these anomalies, as well as evaluate the diagnosis methods and managment options. Material and method: The handbooks of the pacients submitted to surgical treatment for first branchial cleft anomalies in the period between January 1991 and December 1999 were reviewed. Results: In the present series, there were 4 males and 7 females. The age at diagnosis ranged between 8 and 66 years old, with 22,3 year-old average. Seven pacients presented periauricular sinus, three presented cyst lesions and only one had a fistula. The most frequently complaint was appealing infections and purulent discharge periauricular area(72,7%). All the patients were submitted to surgical managment, with recurrence of 27,2%. No others complications were observed. Conclusions: We can conclude that the most frequently form of presentation in patients with first branchial cleft anomalies that need surgical treatment is periauricular sinus with episodes of purulent discharge. Repeted infections and previous drainage difficult procudere and predispose to recurrence.