Imaging plays a fundamental role in the evaluation of patients with head and neck (H&N) neoplasms. Although clinical examination is accurate for the assessment of the superficial extent of tumor, the deep extent is better evaluated on imaging. When clinical examination is precluded by trismus, imaging is the only means of evaluating the oral cavity. The imaging modality must be appropriate for the clinical problem and the imaging technique for the elderly patient must be tailored according to their ability, so as to obtain an optimal examination. In this chapter, we will review the radiological anatomy of the H&N region and the diagnostic imaging features of H&N neoplasms. Identification of normal variations and benign conditions of the H&N is discussed. The vast majority of the H&N masses in the geriatric population are due to cancer, and a wrong diagnosis of benign disease may harm the patient if treatment is delayed. The pertinent findings regarding cancer staging in the different H&N regions and their evaluation following treatment will be discussed.