Background: The United States Food and Drug Administration in 2016 approved immune checkpoint inhibitors (immunotherapy) as a treatment option for head and neck squamous cell carcinoma. However, it is unclear if there are clinical or sociodemographic differences among patients receiving immunotherapy as part of their care. We aimed at characterizing the clinical and non-clinical factors associated with receipt of immunotherapy among elderly patients with head and neck cancer. Methods: We utilized data from Navigating Cancer, which included information on systemic therapy for elderly patients (≥ 65 years), diagnosed with head and neck cancer in a community oncology setting between 2017 and 2021. We estimated clinical (tumor stage [grouped as early, or stage I and II vs. advanced stage, or stage III and IV] and anatomic subsite [oropharyngeal vs. non-oropharyngeal]) and non-clinical (age, smoking history, race, sex, and marital status) factors associated with immunotherapy use based on multivariable logistic regression analysis. Results: There were 4,619 patients in our study cohort, 74.3% male and 87.1% white. Among these patients, 11.1% had received immunotherapy. We found an association between race and receipt of immunotherapy. After adjusting for covariates, white patients with head and neck cancer had 74% increased odds of receiving immunotherapy as part of their treatment (aOR: 1.74; 95% CI 1.25, 2.42), compared to non-whites. There were no statistically significant differences in the odds of immunotherapy use based on age, sex, or smoking history. Patients with non-oropharyngeal disease were significantly more likely to receive immunotherapy than those with oropharyngeal cancer (aOR: 1.26; 95% CI 1.01, 1.56), as were those with advanced stage disease (aOR: 2.72; 95% CI 1.90, 3.91) compared with those early-stage. Conclusions: We identified clinical and non-clinical factors associated with receipt of immunotherapy in this cohort of elderly patients with head and neck cancer, and white patients were significantly more likely to receive immunotherapy as part of their care. Equitable access to immunotherapy and other treatment options will reduce cancer-related health disparities and improve survival of patients with head and neck cancer.