PURPOSE: To evaluate the efficacy of ultrasound-guided percutaneous core-needle biopsy in establishing histopathologic diagnoses of cervical lymphadenopathy. MATERIALS AND METHODS: Seventy nine patients with cervical lymphadenopathy without a history of malignancy or recent infection underwent ultrasound-guided core-needle biopsies. Lymph node tissues were obtained by 2 to 4 times of freehand core-needle biopsy technique using a 7.5-12 MHz ultrasound transducer and a short-excursion (12 mm), spring-loaded automated gun with an 16-gauge cutting needle. We evaluated diagnostic yields of biopsies and related complication. RESULTS: Histologic diagnoses were conclusive in 73 cases (92.4%) including 57 benign causes (24 cases of tuberculous lymphadenitis, 19 cases of reactive hyperplasia, 14 cases of Kikuchi Disease and 2 cases of nonspecific lymphadenitis) and 12 malignancies (8 cases of metastatic lymphadenopathy, 7 cases of lymphoma). In 5 of 7 patients with lymphoma, histologic subclassification was established with obtained tissue to guide treatment. No complications were seen after biopsy. CONCLUSION: Ultrasound-guided core-needle biopsy of cervical lymphadenopathy is a safe, minimally invasive alternative to surgical biopsy, enabling a histologic diagnosis for treatment planning in the majority of cases.