Background: Worldwide Head and Neck Cancers represent the sixth most common neoplasia and accounts for 6% of all cases, being responsible approximately for 1%–2% of tumor deaths.1 In India, they constitute 20%–30% of all cancers. The most common risk factors are consumption of tobacco and alcohol. Betel nut chewing with or without tobacco is a major risk factor for HNC in India, especially in Andaman & Nicobar Islands. Materials and Methods: This was a hospital–based retrospective study to measure the descriptive scenario of Head and Neck Cancer cases. A total of 228 patients old, new and referred diagnosed from June 01, 2018, to December 31, 2018, were included in the study. The data was analyzed for age, gender, subsites, stage at diagnosis, pattern and prevalence of tobacco usage. The Relative Risk and its 95% confidence interval was calculated to assess the association of head and neck cancer with alcohol abuse and tobacco habits. Results: out of 228 cases that were included in the study 165 (72.4%) were males and 63 (27.6%) were females with a male: female ratio of 3.2. the leading carcinoma site in both males and females was the oral cavity. It was also observed that there is more frequency of head and neck cancer among tobacco users which was also found to be statistically significant. Conclusion: Awareness regarding the harmful effects of tobacco and Behaviour Change Communication is warranted on the whole population to reduce the head and neck cancer burden in these islands.