Radiotherapy has an integral role in the treatment of head and neck cancer. Although radiotherapy has the potential to cure patients with advanced disease it also carries the potential for significant long-term morbidity. New technologies in the setting of head and neck radiotherapy are emerging, which have the potential to increase the cure rate and decrease toxicity. These new technologies include improved radiotherapy treatment design (intensity modulated radiation therapy) and improved planning and implementation (image-guided radiation therapy). Some of these advances are discussed in this article.