Soft tissue sarcomas (STS) are a group of heterogeneous tumours that have their origin primarily in the embryonic mesoderm; more than 50 histological subtypes and diverse clinical behaviours have been identified. STS can range from relatively slow growing cancers that cause limited destructive spread to those that are locally aggressive, regionally destructive and associated with great potential for systemic metastases. The approximate incidence for this type of neoplasia is 3–4.5 in 100,000 people, representing approximately 1% of all malignant adult neoplasias. STS in the head and neck region are rare and comprise 5–15% of all adult sarcomas and less than 1% of all head and neck neoplasias. The age at presentation is variable, with a mean of 50–55 years (the minimum is 3 months and the maximum is 89 years). The male/female ratio is approximately 2:1, which varies depending on the review series. The symptoms depend on location, although the most frequently reported symptoms are: headache, nasal obstruction, dysphagia, hoarseness and dyspnoea, but most patients are asymptomatic. The most frequently reported sites of involvement are the: face, neck, scalp, nasopharynx, maxillary antrum, cranial base, and parotid gland. Frequencies at each site differ depending on the published series. There is much histological diversity, although the most frequent types are malignant fibrous histiocytoma and fibrosarcoma. In Mexico, 27 cases were reported by the Instituto Nacional de Cancerologia between 1982 and 1993. The most frequent histological types were rhabdomyosarcoma and malignant peripheral nerve sheath tumors. The General Hospital of Mexico reported 29 head and neck sarcomas cases between 1993 and 1997, with the most frequent histological types being neurogenic sarcomas and leiomyosarcomas. The natural history of head and neck sarcomas is similar to that of sarcomas in other parts of the body, but because of their location, they present greater surgical difficulty. There is often residual disease, which reduces the patient’s life expectancy. The main prognostic factor for STS is histological grade and tumour size. Staging is performed according to the American Joint Committee on Cancer (AJCC) staging, which defines four clinical stages (I–IV), and a second classification system proposed by Memorial Sloan-Kettering Cancer Center (MSKCC). The evolution of disease in head and neck soft tissue sarcomas (HNSTS) frequently involves metastases, most commonly lung metastases. As such, initial management includes a chest X-ray or computed tomography scan. The absence of metastatic lesions excludes the possibility of a systemic disease. In paediatric cases, head and neck sarcomas respond when children are treated with chemotherapy and radiation therapy. In adults, the main treatment modality is surgical, although multidisciplinary treatment is also important because these tumours frequently invade, or are in close proximity to, vital structures. As a result, surgical resection could be incomplete, necessitating local control of disease with adjuvant therapies. The purpose of this study was to review retrospectively adult head and neck sarcomas treated at the Mexico City-based National Institute of Cancerology (Instituto Nacional de Cancerología, INCan) between 2004 and 2009. The aim was to identify prognostic factors and share the authors’ experience regarding treatment performed at this institute.