This review article from MD Anderson discussed current state-of-the-art approaches to reirradiating recurrent head and neck cancer, focusing on advances radiation modalities such as IMRT, SBRT and PBT, and their clinical outcomes. With IMRT, the reported 2-year LC, OS, and PFS rates range from 48% to 67%, 32% to 57%, and 17% to 34%, respectively, with 2-year rates of Grade 3+ toxicity between 26% and 32%. Outcomes after PBT reirradiation are comparable to those reported in IMRT series, with 2-year LC, OS, and PFS rates range from 66% to 79%, 30% to 70%, and 23% to 48%, respectively, and late Grade 3+ toxicity rates were between 26% and 36%, whereas with SBRT, LC and OS ranging from ranging from 26% to 77% and 14% to 67%, respectively, late G3+ toxicity rates range from 13% to 19% at 2-year. Studies that analyzed outcomes of IMRT, SBRT and PBT found no significant difference among the three modalities. The actuarial late toxicity rates after IMRT or PBT reirradiation range between 21% and 48% at 2-years, with a 1%-11% risk of possible treatment-related death. In particular, carotid blowout syndrome (CBS)/carotid blowout (CB) ranged from 0% to 7% with IMRT,  2% to 11% with PBT and 0 to 16% with SBRT. This review provided details in improving disease control and managing toxicity risks, highlighting importance of patient selection and future development.