This is a non-randomized comparison of 98 patients with epidermoid carcinoma of the tonsil treated by preoperative irradiation and surgery and 97 patients receiving irradiation alone. Patients treated with preoperative irradiation received, in most instances, 3,000 rads tumor dose in three weeks through ipsilateral portals, followed within two to six weeks after completion of therapy by an en bloc tumor resection and radical neck dissection. The group treated with irradiation alone received tumor doses in the range of 5,500-6,500 rads in six weeks. No significant difference was noted in the survival yielded by either treatment modality. Both treatment modalities were equally effective in controlling the tumor in the metastatic ipsilateral lymph nodes. In selected cases, a combination of both modalitites may offer better results, but this remains to be proved.