Objective The incidence of deep neck infection (DNI) has been increasing in recent years. Sometimes, the treatment of DNI is intractable. This study aims to improve the clinician"s understanding of this disease and the choice of treatment through the analysis of difficult cases with DNI. Methods Clinical data of 24 patients with deep cervical space infection in our hospital from January 2018 to June 2022 were analyzed retrospectively. Results The male-to-female ratio of 24 patients was 1.67:1, and 17 patients (70.83%) were over 50 years. All patients were treated with antibiotics. 12 patients received surgical treatment, including 6 cases (25.0%) underwent lateral cervical incision and drainage, 2 (8.3%) underwent combining cervicothoracic incision drainage, 5 (20.8%) underwent intraoral incision drainage, 1 (4.2%) underwent percutaneous mediastinal puncture drainage and 1 (4.2%) underwent tracheotomy. There were 7 patients were severe and complex infection involving 3 or more spaces,4 with diabetes, 3 with necrotizing neck fasciitis, 3 with mediastinum abscess and 2 with septicemia. Conclusions Complicated deep neck space infection tends to occur in elderly men and patients with diabetes. Diagnosed early and treated promptly play a critical role in reducing serious complications. Individualized treatment strategies can help shorten the course of infection in different space.