Objective: To explore the clinical features,reasons of misdiagnosis and surgical treatment of recurrent lingual thyroglossal duct cyst(LTGDC) in adults. Methods: Six patients with LTGDC enrolled from January 2018 to March 2020 were analyzed retrospectively. All patients underwent ultrasound B examination to determine the location of the thyroid, CT and MRI scans to evaluate the size, location and the relationship between cysts and hyoid bone. Sistrunk operation were performed for all patients. Results: Four patients were misdiagnosed as epiglottic cyst while the other two patients were misdiagnosed as cysts of the lingual root. All patients have been done operation for 1-3 times. The interval between each surgery and the following recurrence ranged from 3 weeks to 1 year. The results of the pathology examination for all cases showed the cystic wall enclosing the epithelium, which is consistent with thyroglossal duct cyst. During the postoperative follow-up period over 1 year, there is no recurrence. Conclusion: Under laryngoscopy, the cysts located at the region of the tongue should be differentiated LTGDC from the other cysts. Besides the laryngoscopy, all the cases should have done the imaging examinations include ultrasound B examination and CT scans to evaluate the relationship with the hyoid bone and the foramen cecum. Sistrunk surgery is the effective treatment for LTGDC to avoid the recurrence.