The incidence of radiation-induced sarcoma (RIS) in head and neck region is increasing in trend nowadays. There are few cases have been reported. However, the exact aetiology of radiation-induced sarcoma (RIS) is still unknown. We report two cases of radiation-induced sarcoma (RIS) which the primary malignancy were basal cell carcinoma of the cheek and nasopharyngeal carcinoma. These patients had received a total of 70Gy and 65Gy radiotherapy for 13 years and 6 years back respectively. Histopathological examinations for both of these patients revealed a spindle cell sarcoma and a high-grade sarcoma respectively. Both cases were inoperable in view of advanced disease at presentation. We will discuss on the clinical findings, histopathological findings and the main characteristic of radiation-induced sarcoma (RIS) in imaging. The dilemma of managing radiation induce sarcoma in head and neck patient will also be discussed as managing previously radiated head and neck primary is undeniable challenging