The past several years have seen dramatic changes in imaging of the head and neck. Technical improvements in CT and MRI coupled with their widespread availability have made cross-sectional imaging an important adjunct in evaluation of patients with disease of the extracranial head and neck. The most recent advances in head and neck imaging are from new metabolic and functional imaging techniques. The intent of this report is to provide an update on the potential role of positron emission tomography, new MRI agents, and magnetic resonance spectroscopy for evaluating squamous cell carcinoma of the extracranial head and neck.