Background: Right-sided chyle leaks are an uncommon but potentially severe complication in neck surgery. The prevalence of chyle leaks occurring on the left-side of the neck following damage to the thoracic duct is well-documented, but there is limited literature regarding the prevalence and management of right-sided chyle leaks. We aim to highlight the prevalence of right-sided chyle leaks in a high-volume Head and Neck unit, provide an overview of the anatomy and variations of the lymphatic system in the right side of the neck, and conduct a systematic review of the literature with regard to its prevalence and management. Methods: A retrospective review of a total of 4547 right-sided neck dissections was conducted in Sydney Head and Neck Cancer Institute Database. Patient charts were individually examined to determine the local prevalence of post-operative right-sided chyle leaks. A systematic review of existing scientific literature was performed to identify the existing prevalence and management regimes of right-sided chyle leaks. All study types reporting a right-sided chyle leak were included, with reports on left-sided chyle leaks or bilateral neck dissections excluded. Databases included MEDLINE®, Embase®, PubMed, Google Scholar and Scopus, with the last search conducted in October 2023. Results: A total of five right sided chyle leaks (0.11%) were identified from the data during the study period, with two (40%) of these cases consisting of high-volume leaks which required a return to theatre. The systematic review identified 15 publications for inclusion, these reported an incidence of chyle leaks ranging from 0.75% to 8.9%. Conclusion: High-volume right-sided chyle leaks occur infrequently and may be due to the presence of anastomosis between the right and left-sided thoracic ducts. It is imperative that Head and Neck surgeons remain vigilant in lymphatic duct ligation in both right and left-sided neck dissections.