This study reported results of 61 patients with HPV-positive oropharyngeal cancer treated with mucosal sparing radiation therapy. 44 (72%) patients were treated with PT and 17 (28%) were treated with IMRT. With follow-up time 38 months, the 2-year local control, locoregional control, distant metastasis-free survival, and overall survival were 98%, 97%, 98%, and 100%, respectively. There were 6 grade ≥3 events related to treatment. Two IMRT patients required percutaneous endoscopic gastrostomy tube placement during treatment secondary to significant nausea due to dysgeusia. Patients noted significant QOL improvement over time in the pain, swallowing, speech, social eating, social contact, mouth opening, and use of pain medication domains (all P < .02).