Aims. To investigate the specific rote of FDG-PET in the management of head and neck cancer patients. Methods. In a retrospective study, 112 patients with head and neck cancer treated over a 5-year period had FDG-PET scans. The image of the tumour (local, regional and distant) was compared to, clinical, CT/MRI examination, pathological findings and the clinical course of the disease. Results. FDG-PET correctly identified 95.3% of primary lesions, and 94.1% of the recurrences at the primary site. FDG-PET data was supportive of intended treatment in 31 cases and sufficient to alter the management of seven patients. Conclusions. Overall. FDG-PET has a useful role in the diagnosis of head and neck cancers, and in the demonstration of occult or hidden tumours, distant and metastatic disease. (C) 2004 Elsevier Ltd. All rights reserved.