Introduction <p>Head and neck cancer (HNC) and its treatments often result in visible physical changes, significantly affect patient’s perception. Body image distress (BID) is a growing psychosocial concern among survivors, influencing emotional well-being, social functioning, and quality of life.</p> Objective <p>To assess the severity of body image concerns among HNC survivors visiting tertiary care hospital for post-treatment follow-ups and evaluate its association with clinical, oncological and sociodemographic factors.</p> Methods <p>This cross-sectional study included 110 patients treated for HNC within the past two years who had completed curative therapy. Demographic and treatment data were reviewed, and body image concerns were assessed by validated FACT/ Mc Gill BIS questionnaire. Associations between BID scores and clinical variables were analysed using chi-square, <i>t</i> test, ANOVA, and multiple linear regression analysis.</p> Results <p>The mean age was 49.15 ± 18.03 with male preponderance (76.4%). BID scores were higher among males (<i>p</i> &lt; 0.001), older age groups (<i>p</i> = 0.029), married (<i>p</i> = 0.004), urban residents (<i>p</i> = 0.021). Addictive habits (<i>p</i> = 0.018) and substance used (<i>p</i> = 0.023) were significantly associated to BID. Longer duration since diagnosis (<i>p</i> = 0.058) tends to lower the threshold for the body image discomfort. Advanced stage tumors (<i>p</i> = 0.04) and patients undergoing surgery (<i>p</i> = 0.011) with reconstruction (<i>p</i> = 0.003) indicated increased psychosocial impact. Type of treatment and tumour stage were significant predictors for the body image distress on multilinear regression analysis.</p> Conclusion <p>Body image distress is prevalent yet undiscussed issue among treated HNC patients. Early psychosocial screening and multidisciplinary support, including reconstructive and cosmetic surgeries may improve survivorship outcomes.</p>