Between March 1978 and April 1986, 56 patients underwent planned unilateral, and five patients underwent planned bilateral, radical neck dissections following high-dose twice-a-day radiotherapy, usually with 60Co. Neck dissections were generally performed 6 weeks after radiotherapy. The overall rate of control of disease in the neck in all 61 patients was 81% at 5 years. Patients who underwent neck dissections following radiotherapy had significantly higher rates of neck-disease control than patients treated by radiotherapy alone during the same time period for stages N2A-N3A and N2B-N3B, but not for N1 disease. No carotid ruptures or fatal complications occurred. The rate of wound complications was judged to be acceptable.