The use of intensity-modulated radiation (IMRT) for the treatment of head and neck cancers is less than a decade old, and long-term clinical results both with regards to tumor outcome and late radiation toxicity are still lacking. Despite this limitation, the use of IMRT is gaining popularity. Preliminary clinical experiences have been encouraging, suggesting that the 2 goals of IMRT for treatment of head and neck cancer can be achieved. These goals are improved tumor coverage reflected in high rates of disease control and a decrease of toxicity. The availability of IMRT has forced head and neck radiation oncologists to both rethink old practices as well as potentially introduce new therapeutic paradigms. This review will focus on how IMRT is being implemented into the treatment of head and neck cancer, specifically with regards to target definition and dosing issues.