Abstract : Anomalies of the branchial arches are the second most common congenital lesions of the head and neck in children with second arch anomalies being the commonest. Even though diagnosis of branchial arch anomalies is straightforward, sometimes atypical presentations may cause a dilemma in diagnosis. Complete branchial fistula with internal and external opening is extremely rare. An accurate history with a proper clinical examination is detrimental in all otorhinolaryngology cases and to correlate it with imaging for a complete diagnosis. After diagnosis being established, its crucial to decide an operative approach for excision as to prevent recurrences in future. Here we present 2 paediatric age group cases of second branchial cleft sinus and operative approach done for each of the case with the outcome in terms of recurrence, and recovery time. As for the first case, tonsillectomy done with the excision of branchial cleft sinus whereas for the second case the tract was traced until as proximally as possible and tract was ligated.