Aims: Foregut duplication cysts (FDCs) are rare congenital abnormalities that can be found at any site along the upper gastrointestinal tract. There are few reports in the literature of FDCs presenting in the head and neck region. This study presents 11 cases of foregut duplication cysts managed at the Royal Children’s Hospital Melbourne Australia in the last 10 years, as well as a literature review on the management of FDC. The challenges of differential diagnosis and histopathological confirmation is explored. Methodology: A retrospective search of foregut duplication cysts in the last 10 years was performed. A literature review of foregut duplication cysts in the head and neck region was conducted in Pubmed and MEDLINE. Results: Eleven cases of foregut duplication cysts were identified (6 females, 5 males). Youngest age is 2 days old, with majority under age 2 and one age 8. Five cases were in the head and neck region (4 in tongue, floor of mouth and neck, 1 on the uvula) while 6 were in the intrathoracic and intraabdominal spaces. The differential diagnosis considered were ranula, sialocoele and lymphatic malformation based on radiological features. Eventual management of all cases were complete surgical excision. Follow up of a minimum of 2 years revealed no long-term complications or recurrences. 26 cases of head and neck foregut duplication cysts have been identified in the literature. The majority of these cases were identified either prenatally or at birth. Most were found in the oral cavity. Conclusion: Histologically, foregut duplication cysts can be lined with enteric, neurenteric or respiratory (bronchogenic) cells. Reports of head and neck FDCs are rare, with only 26 cases reported. Our case series are added to the literature. FDC is an important differential diagnosis for congenital cystic head and neck mases that the ENT surgeon shall be cognisant of.