In head and neck cancer, squamous cell cancer in the commonest histology. The patients with early stage are treated with surgery or radiotherapy whereas patients with advance stages need multimodality treatment. Minimal invasive surgery is now utilized for skull base surgery, thyroid and parathyroid surgery. It is possible in head and neck surgery with the advent of endoscopes, fibre optics and high definition cameras. Endonasal approach is used for the lesions in nasal cavity, paranasal sinuses and skull base. Transoral approach for the oral cavity, oropharynx and larynx is used with LASER (TOLS) or robots (TORS). The image guided surgery with CT/MRI, provide accurate intraoperative images that delineate tumour from surrounding normal tissue. Clinical use of intraoperative three dimensional cone beam CT scan imaging is tested. The use of mechanical sutures (staplers) has decreased the pharyngocutaneous fistulas and wound related complications after total laryngectomy. The advances in the various reconstructive techniques in head and neck cancer helps to restore the function with better cosmesis.