Background: Right sided chyle leaks are an uncommon but potentially severe complication in neck surgery. The prevalence of chyle leaks occurring on the left-side of the neck following damage to the thoracic duct is well-documented, but there is limited literature regarding the prevalence and management of right-sided chyle leaks. Objective: To highlight the prevalence of right-sided chyle leaks in a high-volume Head and Neck unit, provide an overview of the anatomy and variations of the lymphatic system in the right side of the neck, and conduct a systematic review of the literature with regards to its prevalence and management. Methods: A retrospective review of 4547 right-sided neck dissections conducted between 2014 to 2023 at Chris O’Brien Lifehouse. Patient charts were individually examined to determine the local prevalence of post-operative right sided chyle leaks. A systematic review of existing scientific literature was also performed to identify the prevalence and management regimes of right sided chyle leaks. Results: A total of five right-sided chyle leaks (0.11%) were identified from the data, with two (40%) of these cases requiring a return to theatre. The literature review identified 93 publications, with 64 publications screened following removal of duplicates and non-English publications. 60 full texts were assessed, resulting in 15 publications and a prevalence ranging from 0-8.3%. Conclusion: High volume right sided chyle leaks occur infrequently and may be due to the presence of anastomosis between the right and left sided thoracic ducts. It is imperative that Head and Neck surgeons are cognizant of the anatomical variations and remain vigilant in ligation to avoid complications.