PURPOSE: To evaluate the diagnostic usefulness of ultrasound-guided cutting-needle biopsy(CNB) with an automated biopsy device in head and neck masses. MATERIALS AND METHODS: A series of 153 consecutive head and neck masses in 133 patients, biopsied with an 18G cutting-needle and automated biopsy device under ultrasound guidance, was analysed for diagnostic yield and complications. Fine-needle aspiration biopsy(FNAB) was also performed on 88 masses and compared with the findings of CNB. RESULTS: Diagnostic specimens were obtained in 135 (88.2 %) of 153 masses. Eighty-four (90.3 %) of 93 lymph node CNBs provided a diagnostic histological specimen. Tuberculous lymphadenitis or chronic reactive hyper-palsia was diagnosed by CNB in 22 cases, but only six case were diagnosed by FNAB. Ten metastatic lymph nodes and two malignant lymphomas diagnosed by CNB were concordant with the findings of FNAB ; the exception was one case in which metastasis involved lymph nodes. Twenty-seven (77%) of 35 CNBs of thyroid nodule provided a diagnostic specimen. Seven of 28 FNAB cases in which CNB failed to provide a diagnostic specimen, revealed two papillary cancers and three benign nodular lesions. Twenty-five CNBs of soft tissue and salivary gland tumors provided diagnostic specimens; the exception was one probable hemangioma (96 %). In six of 11 FNABs of soft tissue and salivary gland masses, a diagnostic specimen was not obtained. There were four cases of hematoma (2.6%) without clinical significance. CONCLUSION: CNB of head and neck masses using an automated biopsy device is a useful and safe method. In the case of thyroid masses, however, FNAB is more useful and safe than CNB.