Computer tomography (CT) and magnetic resonance (MRI) imaging are instrumental in cancer staging in carcinoma of the upper respiratory tract in that they are able to identify local spread and tumor invasion, which can often be only insufficiently evaluated by clinical and endoscopic examination alone. These additional radiologic findings, in conjunction with the clinical examination, aid in choosing the most appropriate therapeutic approach. The evaluation of CT and MRI findings is challenging due to the complex anatomy of the head and neck area. This article reviews the most important anatomical structures for the evaluation of cancer invasion and therapeutic decision-making.