BACKGROUND: The purpose of this study was to present our evaluation of the importance of timing (early vs synchronous vs delayed) in conjunction with transoral laser surgery for head and neck squamous cell carcinoma (HNSCC).METHODS: Articles addressing surgical management via transoral laser surgery for HNSCC were included for review.RESULTS: Twenty-six articles fulfilled our criteria. The overall 5-year disease-specific survival (DSS) was 75.6% (95% confidence interval [CI], 67.3-83.9) and locoregional control was 87.3% (95% CI, 82.3-92.1), respectively. In the synchronous neck dissection group, the mean locoregional control was 89.9% (95% CI, 84.8-95.1) versus 84.5% (95% CI, 56.2-112.7) for the delayed neck dissection group. From studies in which complications were explicitly given, a bleeding rate of 5.3% (95% CI, 3.6-6.9) was established. There were 11.1% of patients who underwent a tracheostomy.CONCLUSION: There is no evidence to indicate that timing of neck dissection after transoral laser surgery for HNSCC has any effect on overall survival (OS). © 2016 Wiley Periodicals, Inc. Head Neck, 2016 © 2016 Wiley Periodicals, Inc. Head Neck 39: 1020-1032, 2017.