Purpose of review: Defining the best practice of surgical care for patients affected by malignant head and neck tumors is of great importance. In this review we aim to describe the evolution of "best practice" guidelines in the context of quality-of-care measures and discuss current evidence on "best practice" for the surgical treatment of cancers of the sino-nasal tract, skull base, aero-digestive tract, and the neck. Recent findings: Current evidence based on certain structure and outcome indicators, but mostly based on process indicators already helps defining the framework of "Best practice" for head and neck cancer surgery. However, many aspects of surgical treatment still require in-depth research. Summary: While a framework of "Best practice" strategies already exists for the conduction of the surgical treatment of head and neck cancers, many questions still require additional research in particular in case of rare histologies in the head and neck region.