OBJECTIVES: The objective of this study is to describe patients diagnosed with recurrent/metastatic squamous cell carcinoma of the head and neck (HNSCC) and examine their healthcare resource utilization (HCRU). METHODS: This is a retrospective study utilizing a claims-based dataset of commercially insured patients with diagnostic evidence of HNSCC of the oral cavity, oropharynx, hypopharynx, and larynx between January 2007 and June 2015. All patients had regionally recurrent (RR; cervical lymph nodes diagnosed ≥6 months after diagnosis) or distant metastatic (DM) disease and a single-cancer diagnosis, were ≥18 years old, and were continuously enrolled in the same health plan for ≥6 months. Descriptive statistics were used to compare patient and disease characteristics and analyze HCRU. RESULTS: A total of 76,561 patients were diagnosed with HNSCC, of which 13% had RR or DM. Among them 407 RR patients and 647 DM patients met the inclusion criteria. Median age was 58 years; 77% of patients were male. Among patients with DM disease, the site of metastasis was not identified in about half the patients; when a specific site was provided, the most common sites included lung (15%) and bone/bone marrow (5%). Incident rate of hospitalizations per person per year and length of hospital stay did not vary by DM site of metastatic disease. HCRU was higher among patients with DM than patients with RR, with more hospitalizations per person per year (DM=1.38 hospitalizations, 95% CI [1.27–1.50]) vs RR=0.52 hospitalizations (95% CI [0.44–0.60]) and a longer average hospital stay (DM=6.2 days vs RR=4.7 days, P≤