Background: Multidisciplinary tumor boards are widely accepted as vehicles for improving patient outcomes in Head and Neck Cancer (HNC). Little work describes their structure and practices. The purpose of this study is to better understand the international practice patterns of multidisciplinary HNC tumor boards. Methods: A cross-sectional survey on head and neck cancer multidisciplinary tumor board practice patterns was developed by a panel of six experts and distributed internationally to HNC providers. The survey interrogated the attendance, participation, operation, and perceptions of multidisciplinary tumor conferences, through a mix of Likert-based, tick box and open-ended questions. Results: One hundred and twenty-three responses (55%) were received from 88 surgical oncologists, 17 radiation oncologists, and 18 medical oncologists from nine different countries. Overall, most HNC tumor boards are led by a surgeon (77%), and most commonly 5-10 minutes (61%) was spent on each case. In 60% of responses, all HNC patients were discussed at their tumor boards, while select cases were presented in 40% of responses. Pathology was routinely reviewed in 75% of sites and imaging reviewed in 95% of sites. In 75% of responses, sufficient time was felt to be spent on each case. Majority (75%) of tumor boards documented their recommendation, with 92% reporting that inability to reach a consensus recommendation was rare. When this occurred, the most common recourse was involving patient decision making (53%), followed by offline discussion until an agreement is reached (38%). Most respondents felt that tumor boards rarely altered the treatment plan (68%), while 37% felt the treatment plan was sometimes altered. Involvement of radiation and medical oncology prior to surgery varied, with 53% sending patients routinely, 32% sometimes, and 15% deferring referral. Logistics was cited as a primary barrier. Surgeons and radiation oncologists agree that the top three reasons tumor boards assist in cancer care are: receiving additional opinion and perspective, coordinating care, and communication. Medical oncologist also found tumor boards enhance clinical trial enrollment. Conclusions: While there are variations in the structure and process of multidisciplinary tumor boards, the majority of management is agreed upon by the treatment team. Areas of improvement include verification of cancer stage, identifying logistics that prevent timely and documentation of recommendations. Identifying the variations from most-common practice should provide a mechanism for improvement.