This chapter reviews neoplastic and non-neoplastic causes of neck and cervical pain, highlighting their clinical features, diagnostic pathways, and management strategies. Non-neoplastic etiologies include musculoskeletal, neurological, inflammatory, and systemic conditions, while neoplastic causes range from head and neck cancers to metastatic disease. Imaging modalities such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography-computed tomography (PET-CT) are emphasized for their role in differentiating benign from malignant processes. This chapter underscores the importance of thorough history taking, physical examination, and interdisciplinary collaboration to ensure accurate diagnosis and effective, tailored treatment.