Objective To investigate the characteristic of cervical lymph node metastasis of hypopharyngeal carcinoma, so as to find appropriate postoperative treatment strategies and improving outcome. Methods The clinical data of 18 cases of hypopharyngeal carcinoma from July 2004 to July 2008 were analyzed retrospectively. All patients received operation without preoperative chemotheraphary or radiotheraphy. The marking specimens from the operation were carefully examined to firm the primary tumor and the distribution of cervical lymph node metastasis. Prognosis and metastasis were observered through the followup period ranged from 3~5 years. Results The total rate of regional cervical lymph node metastasis for 18 patients was 88.9% (16/18) and the highest rates of postive lymph nodes were at LevelⅡ (73.1%) and Level Ⅲ(69.2%). Metastasis to LevelⅣ (8.3%) was rare and no metastic lymph nodes in LevelⅠ, LevelⅤ, Level Ⅵ. Conclusion Cervical lymph node metastasis rate of hypopharyngeal carcinomal is high, primarilly in the homolateral side. The highest rates of postive lymph notes are at LevelⅡand Level Ⅲ. With the increase of the diameter and the downward shift location of metastatic cervical lymph nodes, the prognosis of the patients declined gradually.