During the last 25 years, the treatment of tumors arising in the upper aerodigestive tract has changed fundamentally. Whereas surgery in the 1970s aimed at radical block resection and defect repair from outside, the establishment of transoral laser microsurgery marked a new era of organ- and function-preserving therapy. An international symposium, held on 10 and 11 June 2005 in Göttingen, was dedicated to a critical review and assessment of the current role of laser surgery for the treatment of head and neck cancer. Experts from five continents presented their experiences and scientific results and had an intensive exchange with participants from different countries. The topics of the symposium were focused on the surgical principles of laser resection, the oncological and functional results in comparison with traditional therapy, the difficulties and limits of laser surgery in distinct anatomical regions and on the role of radiotherapy. This report summarizes the most important results and statements and gives an overview of actual developments. The names and addresses of the participants mentioned in this report are appended below.