Increasingly, chemotherapy plays an important part in the multimodality treatment of locally advanced head and neck cancers. Its role in the neoadjuvant, concurrent and adjuvant setting is reviewed. In addition, chemotherapy is often used to palliate cancer related symptoms in patients for whom curative treatment is not possible. The role of new target agents in head and neck cancer is also expanding. The aim of this article is to provide an overview of the role of chemotherapy in head and neck cancers.