Autopsy findings and case histories of 64 cases of epidermoid carcinoma of the head and neck at the Denver Veterans Administration Hospital between 1967 and 1977 were reviewed. Forty percent of these cases had metastases below the clavicles at autopsy. Incidence of metastasis was related to size of the primary lesion. Correlation with nodal involvement was equivocal. Our data was combined with that of similar studies done by O'Brien in 1970 and Gowen in 1963 and resulted in a combined autopsy series of 247 cases. Overall, 47% had distant metastases at autopsy.