The management of children who present with complications of sinusitis and otitis remains controversial. Surgery for drainage of abscesses has been the standard of treatment. Mastoidectomy, open and endoscopic sinus surgery, and incision and drainage are procedures commonly performed to address head and neck abscesses. Recent evidence also supports the use of antibiotic therapy or less extensive surgery for the treatment of these conditions. This Great Debate will discuss both options and indications when pediatric head and neck abscesses are encountered.