Treatment of diseases involving the head and neck is most challenging because of the high density of vital structures in this region, the need to preserve function, and aesthetic requirements. Technical advances in needles, catheters, guide wires, and embolic materials have broadened the scope of interventional neuroradiologic procedures. Endovascular therapy can serve as a valuable adjunct to conventional surgical treatment for head and neck masses. In addition, it is now the treatment of choice for a variety of vascular lesions, such as arteriovenous malformations, arteriovenous fistulas, and pseudoaneurysms. In this article, examples from the spectrum of applications of endovascular therapy in the head and neck region are presented along with a discussion of therapeutic considerations.