Branchial apparatus anomalies usually manifest in teenage or early adult life. Infection complicates
second branchial pouch anomalies usually presented as a neck lump or discharging sinus. It is the most common
form of anomalies compared to another branchial pouch aberrant. However, it is extremely rare to find a
complete branchial fistula with both internal and external openings. Misdiagnosis usually occurs leading to
inappropriate and suboptimal treatment. Here, we report of a case of complete second branchial pouch fistula
and discuss the clinical presentation and surgical management of such lesion.