Squamous cell carcinoma of the head and neck with distant metastases or locoregional relapse not amenable to radical surgery or radiation therapy are incurable. Median overall survival is approximately 10 months and the site of relapse, frequently in the head and neck area, is responsible for important local and regional complications that significantly impact quality of life. This article will focus on the general management and treatment of these recurrent and/or metastatic patients. We will discuss the challenges faced by the clinician when diagnosing tumor recurrence, as well as the indications and the limitations of the locoregional and systemic treatments available to treat this population.