This article focuses on squamous cell carcinoma of the head and neck (SCCHN), the most common malignancy of the head and neck area. Early detection limits morbidity of treatment and increases the chances of a cure. The treatment of SCCHN is often multidisciplinary in nature and provides a model for how multimodality therapy may be applied for optimal patient management. The role of surgery in SCCHN is continually undergoing evolution, and the surgeon's role in the multidisciplinary treatment of head and neck cancers has changed as more cancers are being treated by chemoradiotherapy. Salvage surgery has become more common, and with it the increased challenges in managing metastatic disease to neck nodes as well as managing failure of organ preservation treatments. Surgeons continue to develop and refine reconstruction techniques to optimize cosmetic and functional outcomes.