Abstract Aim The impact of COVID-19 on cancer presentations has been debated; this audit aimed to examine the stage at presentation of head and neck (H&N) cancers regionally during the COVID-19 pandemic compared to the identical time period during 2019. Methods Retrospective data was collected across 3 hospitals in the South West, identifying all H&N cancer patients discussed at Multi-disciplinary Team Meetings between 1st April-10th October 2019 and the same timeframe in 2020. Patients with lymphomas and thyroid neoplasms were excluded due to separate treatment pathways available. Results There were 234 and 272 patients identified in 2020 and 2019 respectively. The median stage at presentation for all cancers was 2 in both years. The commonest cancers in 2020 were oropharyngeal (28%) and oral cavity (22%), similar to that of 2019 (oral cavity-31%, oropharyngeal-22%). The absolute numbers of laryngeal cancers were similar but a greater percentage of those presented late (stages 3&4) in 2020 compared to 2019 (47% vs 35%). There were almost twice as many skin/lip cancers in 2020 proportionately (20% vs 12%) and a greater number of them presented at a later stage. Conclusion Overall, COVID-19 has not appeared to affect the stage at presentation of H&N cancers, reflecting an on-going continuity of care for cancer patients. Subgroup analysis revealed skin and laryngeal cancers was most adversely affected by the pandemic, possibly due to delayed presentation and reduced face-to-face consultations, highlighting the need for continued face-to-face appointments as a part of cancer care pathways.