Esthesioneuroblastoma is an uncommon tumor of the sinonasal region that metastasizes to the neck in approximately 20% of patients. The rate of neck metastases occurring 6 months or more following diagnosis of the primary tumor has not been well characterized, although many studies have reported a significant number of such patients. The rate of successful salvage of these late neck metastases, defined in this study as disease-free survival for at least 1 year, has not been previously reported. We examine the rate of late neck metastases from the largest case series published since 1990. The rate of overall cervical metastases was 20.2%; the rate of late neck metastases was 12.4%. The overall rate of successful salvage of late neck metastases with surgery, radiation, or a combination of the two was 31.2%. Surgery plus radiation provided a statistically significant increase in the rate of salvage in patients with late neck metastases, with an odds ratio (OR) of 8.6 vs. single modality therapy, with a number-needed-to-treat of three. We found no difference in the odds ratio for successful salvage for surgery vs. radiation (OR = 1.5). The rate of local recurrence in esthesioneuroblastoma is approximately 30%. No standardized regimen for salvage treatment has been developed, and large studies on the rate of successful salvage of local recurrence have been difficult to assemble. Here we report data from 678 patients on the rate of local tumor recurrence from the largest series of treatment of histologically confirmed ENB published since 1990, as well as an OR analysis of failed salvage of local recurrence for patients treated with surgery alone, radiation alone, or combined surgery and radiation therapy. We found a 28.5% rate of local recurrence after initial treatment, as well as a cumulative 42.6% rate of successful salvage with surgery, radiation, or combined modality treatment. The data showed that the OR for successful salvage, defined as disease-free survival for at least 1 year, was not significantly different for combined surgery and radiation vs. surgery alone or radiation alone, or for surgery alone vs. radiation alone. The OR for successful salvage for SRT vs. RT alone (3.5) approached, but did not reach, statistical significance.