Although up to one-fourth of squamous cell carcinoma of the head and neck cases are older than 70 years, specific guidelines for treatment of this elderly population are scarce. Elderly patients are often excluded from chemotherapy clinical trials because of safety reasons. Chemotherapy complications such as neutropenia, anemia, mucositis and nephrotoxicity are more frequently observed in the elderly, which often leads to dose reduction of chemotherapeutic agents. However, a priori dose reduction based purely on chronological age may adversely affect efficacy of treatment especially in the setting of definitive or adjuvant chemoradiotherapy. Given the favorable toxicity profile of cetuximab-combined immunoradiotherapy, its use with concurrent radiotherapy might be an alternative in elderly patients unfit for cisplatin based chemoradiotherapy due to nephrotoxicity, ototoxicity or neuropathy. In patients with metastatic or incurable locoregional disease, the aim of the treatment is palliation. More efforts should be made to avoid toxicity In this group. In an effort to minimize toxicity without compromising efficacy, age-adjusted regimens should be developed.