Abstract: Objective: To analyze the treatment methods and prognostic variables of synovial sarcoma in the head and neck. Methods: Data from 8 cases with synovial sarcoma in the head and neck treated in The Affiliated Tumor Hospital of Harbin Medical University from May 1975 to December 2006 were analyzed. Five patients underwent simple surgery, 1 patient received radiotherapy alone, 1 patient received surgery plus radiotherapy, and 1 patient received no therapy. Thirty-six similar cases abroad were also reviewed. Results: The clinical manifestations of synovial sarcoma in the head and neck were not specific. The treatments failed because of unclear origins of infiltrative growth and the difficulty in identifying the tumor margin and extent of radiation therapy. The abundant nerves and vessels in the head and neck were the major factors impacting prognosis. The overall 5-year survival rate was less than 20%. Conclusion: There was no specific method to diagnose synovial sarcoma in the head and neck. Immunohistochemistry is helpful. At present, there are no effective chemotherapeutics. The recurrence rate after simple surgery or radiotherapy alone is high. Standard surgery combined with radiotherapy is the most effective treatment and can increase patients' survival rate over either treatment alone.