The tonsillar area is a relatively uncommon site for cancer. Because of this fact, the medical literature contains few reports covering a large number of cases. From the material which has been published (3, 5, 9, 10, 11), it is apparent that the pattern of management of patients with this disease has been fairly uniform for the past fifteen years. Since progress depends on a periodic evaluation of the results of any treatment, it has seemed worth while to review at this time a group of cases with the diagnosis of carcinoma of the tonsil treated with irradiation during the past ten years. Material Studied This study is based on all the patients with carcinoma of the tonsil irradiated at the Collis P. Huntington Memorial Hospital from 1936 through 1941 and at the Massachusetts General Hospital from 1936 through 1945. Since the primary site of an extensive tumor in the mesopharynx is often impossible to determine, only those cases in which it was reasonably certain that the lesion was located at the palatine tonsil, the tonsillar fossa, the tonsillar pillars, or in the triangular fold have been considered. Excluding one case in which the tumor later proved to be a Kaposi sarcoma, 90 cases were found and analyzed. In the series, there were 76 (84 per cent males and 14 (16 per cent) females. The median age was sixty-five, the oldest patient being eighty-seven and the youngest twenty-nine years. These figures correspond with those reported by Schall (9) and Lierle (5), and confirm the common belief that cancer of the tonsil occurs most frequently in males in the seventh decade of life. Because of the insidious onset of malignant disease, patients almost universally procrastinate in seeking medical advice. The median delay in treatment in this group was three months. The duration of disease (symptomatically) at the time treatment was instituted ranged from one day (?) to over two years. The most frequent presenting complaint was soreness of the throat, which was noted in 54 per cent of the group. Swelling of the neck was the first sign in 46 per cent, difficulty in swallowing in 16 per cent, bleeding in 15 per cent, weight loss in 4 per cent, and hoarseness in 2 per cent. A noteworthy fact is that in only 9 per cent was a growth in the mouth observed. Lymph-node metastases are often the first indication to the patient that he has the disease. Sixty per cent of the group presented enlarged nodes when they were first seen, and in two-thirds of these the “lump in the neck” was the first subjective sign to be observed. Of those who had no palpable metastases at the time of first examination, 8 per cent later showed cervical lymph node involvement. No attempt has been made to correlate the metastatic spread of the cancer with the grade of malignancy of the lesion, but the evidence suggests that tumors classified as Grade I (Broders) did not metastasize early, although they were locally recalcitrant in responding to irradiation.