Background: Surgical management of head and neck cancer is undoubtedly challenging, and we would like to see the outcome of managing such cases at one of the tertiary referral center in the East Coast of Malaysia. Methods: A 6-year retrospective analysis of surgically treated head and neck cancer cases in Hospital Tengku Ampuan Afzan (HTAA) Kuantan, Pahang was conducted. Results: The total number of patients reviewed was 55 and mean age of the patients was 59 years (SD 12). The larynx was the most common surgically treated site (29.1%), followed by the oral cavity (16.4%) and the paranasal sinuses (14.5%). Majority of the patients presented with stage III (32.8%) and stage IV (41.8%) cancer. Post-operative local complications (23.6%) and wound breakdown was identified as the most common cause (20%). Low hemoglobin level prior to surgery was associated with anemia after surgery (P = 0.007) and prolonged hospital stay (P = 0.030). Tumor recurrence was observed in 21.8% of the cases. Advanced stage tumor had more percentage of positive margin than early stage tumor i.e., 23% in early stage versus 58% in advanced stage (P = 0.050). Conclusion: Surgical management of head and neck cancer in this center has an acceptable outcome.