Objective To investigate the clinical features of patients with deep cervical multi-space abscess, and to preliminarily analyze the therapeutic effect of abscess drainage through the natural communication channels between the anatomical spaces. Methods Clinical data of 17 patients with deep cervical multi-space abscess were retrospectively analyzed. All patients underwent open drainage surgery after diagnosis. During the operation, a semi-tube drainage was placed through the natural communication channels between the anatomical spaces in the neck, the surgical incision was opened, and anti-infection and systemic supportive treatments were strengthened. The drainage tube was removed after the secretions in the surgical area disappeared, and the incision was closed in the second phase after healthy granulation tissue grew on the wound. Results Among the 17 patients, 13 were male and 4 were female. The age ranged from 28 to 76 years, with an average age of 56.3 years. The causes of the disease included dental infection in 9 patients (52.9%), a history of foreign body in the pharynx in 3 (17.7%), and unascertainable source of infection in 5 cases (29.4%). The abscess was located in the suprhyoid area in 15 patients (88.2%) with simultaneous subhyoid space abscess in 5 of them (29.4%), and subhyoid space in 2 cases (11.8%). The abscess involved submandibular space in 16 patients (94.1%), parapharyngeal space in 13 patients (76.5%), parotid space in 2 patients (11.8%), subtemporal space in 1 patient (5.9%), pterygomaxillary space in 1 patient (5.9%). The abscess extended through the cervical sheath to the anterior superior mediastinum in 2 patients (11.8%). In the results of bacterial smear and secretion culture, bacteria were cultured in 8 patients, including 4 cases of Klebsiella pneumoniae and 1 case of Klebsiella acidogenes (all with diabetes), 2 cases of Streptococcus angina, and 1 case of Escherichia coli. There were 2 cases of Gram-positive cocci with unknown details of bacterial smear. No bacterial growth was observed in 7 cases. One patient with involvement of the parotid space was cured by incision and abscess drainage twice. One patient had bleeding at the neck drainage site on the sixth postoperative day, with local compression not effective, and was cured by right external carotid artery embolization. One patient with lower gastrointestinal tumor died of acute lower gastrointestinal hemorrhage during hospitalization. All the other patients were cured and discharged. The average time for removal of drainage tube was 11 to 20 days, with an average of 16.3 days.The duration of hospitalization ranged from 11 to 49 days, with an average of 24.3 days. Conclusion By opening the natural communication channels between the deep neck interspaces, abscess drainage is ensured to allow adequate drainage, facilitate dressing change and observation of infection control, and multiple incision can be avoided. Combining sensitive antibiotics and nutritional support, drainage through the natural communication channels is an effective method for the treatment of deep neck multi-space abscess.