Pattern of otorhinolaryngoloy head and neck diseases in Outpatient Clinic ( ENT OPD Clinic) varies depending on the countries to large extent. A retrospective study was done on all the patients seen in the ENT OPD Clinic of Sarawak General Hospital from July 2003 to June 2004. There were 8118 patients, including 974 new patients (12%) & 1112 paediatric cases (13.7%). The male to female ratio is 1: 1.3. The age ranges from one-month-old to 92 years old, with a male mean of 38 (SD 31.6) and female mean of 41 (SD 33.4). The new cases were referred from Hospital Accident & Emergency Department (15.3%), other Specialty Clinics (22.0%), peripheral general clinics, called Polyclincs locally (41.7%), follow-up after treatment in In-Patient wards (6.6%), other public hospitals ( 7.0%), private clinics (2.3%), and miscellaneous ( 5.1%). The top 5 most common groups of ENT diseases are rhinitis (20.2%), chronic otitis media (12.3%), nasopharyngealcarcinoma (NPC) (10.5%), tonsillitis (8.1%) and nasal polyposis (5.2%). In these 5 groups, majority of the diseases were allergic rhinitis, central or large subtotal perforations of eardrum, recurrent or chronic tonsillitis (mainly in children) and ethmoid polyps. The incidence of NPC is relatively high in male and in ethnic groups of Bidayuh and Chinese and of the pathology WHO Types II & III. The findings help defining the content and extent of medical curriculum in otorhinolaryngology, thereby enriching the local medical graduates in their pursuit of relevant knowledge and skill in managing the relatively common and prevailing ENT diseases locally.