Objective: To determine the feasibility of roboticassisted salvage surgery for oropharyngeal cancer. Design: Retrospective case-controlled study. Setting: Academic, tertiary referral center. Patients: Patients who underwent surgical resection for T1 and T2 oropharyngeal cancer between 2001 and 2008 were classified into the following 3 groups based on type of resection: (1) robotic-assisted surgery for primary neoplasms (robotic primary) (n=15), (2) robotic-assisted salvage surgery for recurrent disease (robotic salvage) (n=7), and (3) open salvage resection for recurrent disease (n=14). Main Outcome Measures: Data regarding tumor subsite, stage, and prior treatment were evaluated as well as margin status, nodal disease, length of hospital stay, diet, and tracheotomy tube dependence. Results: The median length of stay in the open salvage group was longer (8.2 days) than robotic salvage (5.0 days) (P=.14) and robotic primary (1.5 days) resection groups (P<.001). There was no difference in postoperative diet between robotic primary and robotic salvage surgery groups. However, a greater proportion of patients who underwent open salvage procedures were gastrostomy tube dependent 6 months following treatment (43%) compared with robotic salvage resection (0%) (P=.06). A greater proportion of patients who underwent open salvage procedures also remained tracheotomy tube dependent after 6 months (7%) compared with robotic salvage or robotic primary patients (0%) (P=.48). No complications were reported in the robotic salvage group. Two patients who underwent open salvage resection developed postoperative hematomas and 2 developed wound infections. Conclusion: When feasible, robotic-assisted surgery is an acceptable procedure for resection of both primary and recurrent oropharyngeal tumors. Trial Registration: clinicaltrials.gov Identifier: NCT00473564. ©2010 American Medical Association. All rights reserved.