Squamous cell carcinoma of the head and neck induces neovascularization to support tumor growth and facilitate the metastatic spread. Others have suggested that the density of microvessels within the tumor correlates with the neovascularization process and therefore with clinical behavior and outcome. To ascertain the value of the microvessel count as an independent prognostic indicator for squamous cel carcinoma of the head and neck, we studied the primary tumors of 44 patients. Histological slides were stained for factor VIII and the individual microvessels were counted on a 200 x field (0.49 mm). No statistically significant difference was found between the microvessel counts of tumors that metastasize or recur locally, as compared with tumors that did not. The possibility of a beta-error due to the small number of cases mandates a larger possibly multi-institutional, study to better ascertain the significance of a microvessel count as an independent prognostic indicator.