Aims: Oesophageal inlet patch (OIP), an area of heterotopic gastric mucosa in the proximal oesophagus, is frequently underdiagnosed due to non-specific symptoms. This study aims to highlight OIP as a differential diagnosis for undifferentiated neck pain in paediatric patients. Methodology: We present a case of a 10-year-old girl with a 6-week history of persistent anterior neck pain, globus, dysphagia, and odynophagia. Standard investigations were unremarkable, and diagnosis was confirmed after laryngo-broncho-oesophagoscopy and biopsy. A systematic review was also conducted using PubMed/MEDLINE, EMBASE, and Scopus to identify studies involving paediatric patients (aged ≤17) with confirmed OIP in the proximal oesophagus. Data on patient characteristics and clinical features were extracted. Results: Eight studies encompassing 74 paediatric patients without other underlying conditions were included. The majority (54.1%) were asymptomatic, with dysphagia (17.6%), abdominal/epigastric pain (9.46%), and cough (5.41%) as common symptoms. Other reported symptoms included globus, pyrosis, vomiting/haematemesis, and odynophagia. No study documented neck pain as an isolated symptom, underscoring the rarity of our case, which identified OIP as a potential source of persistent neck pain. Conclusion: OIP should be considered a differential diagnosis in paediatric patients presenting with undiagnosed neck pain. Early recognition and treatment are vital to prevent complications such as oesophageal strictures or perforation.