Oral squamous cell carcinoma (OSCC) is the most common malignant tumor in the oral and maxillofacial regions. Cervical lymph node metastasis is not only an important biological behavior of oral cancer but also an important factor affecting the prognosis of oral cancer patients. As neck dissection is the most commonly used method of neck management, the appropriate choice of surgical procedure is very important. The current view is that radical neck dissection or modified radical neck dissection can be used for patients with clinically node-positive neck (cN+), while selective neck dissection can be used for patients with clinically node-negative neck (cN0). In recent years, selective neck dissection has been increasingly popularized and applied. Its implications are also gradually expanding from cN0 to cN+. However, there is still no consensus on whether selective neck dissection can also be used in patients with cN+ necks. This article reviews the clinical studies on the neck management of cN+ OSCC patients in recent years, analyzes the effects of different neck dissections on the prognosis of cN+ OSCC patients, and summarizes the treatment principles of neck management.