The primary source of information that clinicians use when evaluating and managing patients with cancer is the surgical pathology report. Omission of critical information from the report is a recognized problem in pathology, especially considering the expanding amount of information, such as molecular diagnostics data, that is now routinely included in reports. To standardize surgical pathology reports, the College of American Pathologists (CAP) introduced the CAP checklists. In 2004, the American College of Surgeons Commission on Cancer mandated that 90% of pathology reports indicating a cancer diagnosis at participating centers contain all scientifically validated or regularly used data elements. The University of Pittsburgh Medical Center has implemented synoptic reporting based on the CAP checklists for all major tumor types. We report our experience with synoptic reporting on head and neck neoplasms, demonstrating, in particular, how this can be customized according to needs of each institution.