Background. Our aim was to determine exercise preferences among patients with head and neck cancer and their associations with quality of life, symptom severity, depression, and rural residence. Methods. This study involved a cross-sectional chart review and self-administered survey, with 90 outpatients with head and neck cancer (response rate = 83%). Results. The majority were <65 years old (65%), male (78%), and white (96%) with stage ≥III (81%). Lack of preference was the most frequent option for counseling source (66%), counseling delivery (47%), and exercise variability (52%). Popular specific preferences included outdoors (49%), morning (47%), and alone (50%). Significant adjusted associations occurred for patients' interest with lower functional wellbeing, alone with higher functional well-being, and morning with higher total quality of life and emotional, social, and functional well-being. No significant associations occurred with symptoms, depression, or rural residence. Conclusion. Patients with head and neck cancer may be open to a variety of exercise options. Quality of life may influence interest and preference for exercising alone or in the morning. © 2009 Wiley Periodicals, Inc.