BackgroundOver the past year at least 10 case series and several case reports on osteonecrosis of the jaw (ONJ) have been published with most found in the oral surgery literature. This clinical entity is largely unknown to head and neck surgeons.MethodsRetrospective chart review.ResultsA total of 479 charts were reviewed, identifying 25 individuals meeting inclusion criteria. Mean age was 63.4 (standard deviation, 9.9) years; 40% were female. Multiple myeloma was the most common comorbidity. Twenty‐five patients were treated with bisphosphonates for 4.4 years (range, 1 to 8 years); most commonly pamidronate before ONJ diagnosis. Forty‐two percent (10) took steroids within the month before diagnosis. Fifty‐two percent (11) underwent dental work before developing ONJ.ConclusionThese data reflect the importance of awareness of the possibility of ONJ with bisphosphonate therapy.