Both primary and recurrent squamous cell carcinoma of head and neck cancers are classic indications for brachytherapy. A high rate of local tumor control at the cost of limited morbidity can be achieved with brachytherapy through good patient selection, meticulous source implantation and careful treatment planning. With the aid of new technologies such as three dimensional imaging (3D) and image guided brachytherapy it is now easier, safer and much more accurate improving the conformality of treatment.