Objective: Neck dissection remains the standard method of treating cervical metastasis from head and neck squamous cell carcinoma. We reviewed our experience with radical and modified RND (MRND) plus radiotherapy as treatment for N2/N3 neck disease in head and neck squamous cell carcinoma. Methods we retrospectively reviewed our clinical records from july 2010 to june 2014 identify 43 neck dissections in 39 patients who were found to have N2 or N3 neck disease treated primarily by neck dissection and postoperative radiotherapy. All patients had head and neck squamous cell carcinoma with a minimum follow up of 24 months. Conclusions the combination of RND or MRND and radiotherapy is effective in controlling neck disease in the absence of persistent or recurrent local disease. MRND supports preservation of the spinal nerve whenever oncologically feasible.