This chapter discusses salvage surgery, which is defined as surgery applied for the resection of residual or recurrent disease after failure of primary or chemo radiation. Salvage surgery after primary radiation is challenging and should only be performed in centers and by surgeons with vast experience in major head and neck surgery. Salvage surgery in curative intent for resectable disease has to be performed with adequate margins as no additional adjuvant radiation will be possible in most cases. Salvage surgery should be restricted to selected patients in good general health with tumors amenable to complete radical resection. Cancer of the oral cavity and oropharynx that recurs locally after initial radiation presents a difficult management problem. The aims of treating a head and neck squamous cell carcinomas (HNSCC) of the larynx are to control disease and to preserve the ability to eat, drink and talk.