This review presents several relatively new areas of interest in radiotherapy for head and neck neoplasms. In the clinical arena, improving radiotherapy outcome by altering radiation schedules has undergone rigorous testing in patients with squamous cell carcinomas. The initial results show that such an approach increases the local control rate in subsets of patients by 10% to 15%. Randomized multi-institutional studies, sponsored by large cooperative groups, are ongoing to assess the relative merits of various altered fractionation strategies. In the field of laboratory investigations, attempts have been made to develop tests reliable in predicting the radiation response of tumors and normal tissues. If successful, it would be possible to design the optimal radiation regimen for individual patients based on the results of these tests, thereby improving the therapeutic ratio. Technologic innovations have enhanced the flexibility to conform radiation to the target volume so that higher doses can be delivered to the tumor without exceeding the tolerance of the surrounding normal tissues. Large-scale clinical studies evaluating the value of conformal therapy are being developed. Finally, long-term results of radiotherapy in the management of chemodectomas have been reported in recent years. These data have clearly defined the role of radiotherapy in the treatment of skull-base paragangliomas.