Organ function preservation in patients with head and neck cancer can be achieved by intensity-modulated radiation therapy (IMRT). Much of the work on the physics of IMRT has been done for currently available IMRT systems. However, clinical data remain scarce. Before IMRT is accepted as a standard of care, more comprehensive clinical data on the outcomes of IMRT are needed to substantiate its superiority and advantages over conventional modes of radiotherapy. Concomitant chemoradiation and altered fractionation schemes improve local-regional control, but at the cost of increased toxicity. This article presents a 3-year update of the toxicity profile and therapeutic outcomes of 126 patients with head and neck carcinoma treated with IMRT. An ongoing trial of concomitant chemotherapy and IMRT with subcutaneous amifostine (Ethyol, WR-2721; MedImmune, Inc, Gaithersburg, MD) for organ function preservation is also discussed.