AbstractObjectiveQuality of life (QOL) is an important consideration in head and neck cancer (HNC) due to lasting disease and treatment‐related toxicities. We performed a comprehensive review of predictors of QOL in this population, including distance to care.Study DesignRetrospective cohort study from 2017 to 2022.SettingAcademic medical center.MethodsQOL was quantified in patients treated for HNC utilizing the University of Washington Quality of Life and 20‐Item Short Form surveys completed at subsequent clinic visits. Distance to treatment center and other demographic, socioeconomic, disease‐specific, and behavioral data were analyzed.ResultsThere were 176 patients in the cohort (69% male; mean age, 64 ± 10.8 years). There was no association between miles traveled and any of the QOL subscales. Marital status was the strongest predictor of QOL, significantly associated with 7/8 QOL domains and favoring those who were married. Other significant predictors of decreased QOL included emotional/physical abuse, current tobacco use, documented religious affiliation, and treatment involving surgery plus adjuvant therapy. A significant positive trend over time existed for multiple QOL subscales.ConclusionQOL is unchanged in patients who travel greater distances for care. QOL is more closely linked to factors such as marital status, physical/emotional abuse, tobacco use, religious affiliation, treatment intensity, and time following surgery. This highlights the importance of a strong support structure and the influence of certain socioeconomic and lifestyle factors on patients, with opportunities for screening and intervention throughout their cancer care.