UNLABELLED: The retropharyngeal space is a distinct space along the midline that extends from the skull base to the upper mediastinum. Retropharyngeal space lesions can produce significant morbidity, given their proximity to the aero-digestive tract, skull base and its ability to extend into upper mediastinum. Difficulty in assessing the retropharyngeal space by direct inspection or physical examination may cause delay in diagnosis and early intervention thus knowledge about these lesions and their effective management is essential. This is a retrospective analysis of 10 cases evaluated at the ENT Department of Bangalore Medical College and Research Institute with a diagnosis of various retropharyngeal space lesions. Retropharyngeal abscesses (6 cases) were managed surgically by incision and drainage along with antibiotics based on culture and sensitivity, out of which one was of tubercular in origin which was managed with anti tubercular drugs(ATT). Cervical osteophytes (2 cases) were managed conservatively. Retropharyngeal Myxoma(1case) was managed with intra-oral excision. Ca lung with SVC syndrome masquerading as Ludwig's angina with Retropharyngeal space collection (1 case) was managed with palliative chemoradiation. Retropharyngeal space lesions can have a wide range of differentials, all of which should be borne in mind and unnecessary intervention avoided while making a more definitive diagnosis. This study highlights the clinical presentation, effective diagnostic modalities, and treatment of various retropharyngeal space lesions. Ruling out differential diagnoses aids in the early and effective management of the retropharyngeal space pathologies, thus helping reduce morbidity and mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12070-024-05168-8.