BACKGROUND : Recently, time to treatment initiation has been observed to be increasing specifically for head and neck cancer. It is acknowledged that the pattern of increase is reflective of the use of sophisticated diagnostic and therapeutic techniques but was also determined to affect survival. OBJECTIVE : Our study sought to further investigate time to surgery (TTS) for surgically treated patients to see whether TTS would influence patient survival. METHODS : TTS was defined as the time from the earliest pathological report or scan, whichever was earlier, to surgery. The endpoints were overall survival (OS) and event-free survival (EFS). RESULTS : A total of 294 patients with head and neck cancer were included. Patients were organized into TTS quartiles of 0-14 days (quartile 1), 15-29 days (quartile 2), 30-49 days (quartile 3), and ≥50 days (quartile 4). The median follow-up time was 651 days, and the median TTS was 32 days. Using a univariable analysis of Cox regression, TTS was not significantly associated with OS or EFS. Kaplan-Meier curves were not significant for OS (p = 0.8904) and EFS (p = 0.9556). CONCLUSIONS : In this cohort study, we could not conclude that TTS was associated with OS or EFS.