Chemotherapy for head and neck cancer in the adjuvant setting is still experimental at the present time. In general, chemotherapy, given as an adjuvant to surgery and radiation therapy, has not been effective in improving local control or overall survival. Many of the regimens tested would be considered suboptimal by today's standards, and the experimental patient population in these studies have been heterogenous without stringent application of "high-risk" features. Concurrent radiation and chemotherapy seems to be promising and is the focus of ongoing research efforts. The true role of this approach will have to await the completion and analysis of currently active trials, such as the intergroup high-risk adjuvant trial.