The treatment of advanced squamous cell carcinoma involves a multidisciplinary approach among various physicians and ancillary personnel. The role of the head and neck surgeon continues to change, as concurrent chemotherapy and radiotherapy protocols have evolved in the initial management of this challenging patient population. More and more, the surgeon is called upon to operate on those patients with persistent or recurrent disease despite initial treatment with chemotherapy and radiotherapy. The purpose of this article is to analyze complications and outcomes of surgery in patients who have already received radiotherapy and chemotherapy.