There are few data focusing on postoperative course after major head and neck cancer surgery in the elderly compared with the younger population. The aim of this study was to assess the impact of age on postoperative outcomes. At hospital admission, we prospectively collected data from 261 patients separated into two groups with regard to their age (those >or= 70 years and those < 70 years). Twenty-nine of them were over 70 years old. Median length of stay was similar in both populations (22 vs. 21 days, p=0.66). Incidence of severe postoperative complications was similar: surgical site infection (6/29 vs. 89/232, p=0.77), pneumonia (4/29 vs. 29/232, p=0.13) and infection caused by multi-resistant pathogens (1/29 vs. 14/232, p=0.08). There was no significant increase in postoperative deaths (4/29 vs. 6/232, p=0.12). The impact of age on postoperative deaths was assessed after adjustment for potential risk factors. In a logistic regression model, postoperative death risk remained insignificantly increased in the elderly (adjusted Odds Ratio=3.3 [0.7-14.9], p=0.22). In our experience, the postoperative course in elderly patients is not significantly different from that than in younger patients.