OBJECTIVES:  Real-world treatment and outcomes in patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) after platinum therapy are largely unknown. In light of emerging therapies, a retrospective chart review was conducted in France to characterize the experiences of patients with R/M SCCHN who have been previously treated with a platinum-based regimen. METHODS:  Real-world data were collected through a chart review. Included were patients randomly selected from all adults aged ≥18 years diagnosed with SCCHN at treating sites between January 1, 2013 and June 30, 2014 to meet an a priori sample-size calculation. Patients were followed through August 20, 2016 or until death. Clinical trial participants were excluded. Demographics and treatment data were analyzed descriptively. Overall survival (OS) was quantified using Kaplan-Meier analysis censoring for date of chart abstraction in surviving patients. RESULTS:  Twenty-three oncologists contributed data for a random selection of 204 patients; 86% were men and 97% were current or former tobacco users. The mean (SD) age was 63 (10.5) years at initial R/M SCCHN diagnosis. Most patients (89%) were treated first-line with a platinum-based regimen, and 117 (65%) of these patients progressed to second-line treatment. Second-line treatment among these 117 patients consisted largely of monotherapy with a taxane (33%), cetuximab (21%), or methotrexate (12%) irrespective of disease stage (ie, IVC vs non-IVC), and 98 (84%) patients were identified as being second-line platinum-refractory (ie, did not receive second-line platinum). Among those receiving second-line treatment, median OS from first-line initiation was 14.6 (95% CI: 13.0, 16.3) months. CONCLUSIONS:  More than half of the patients in this chart review received second-line treatment following first-line platinum-based therapy, but median survival remained well under 1.5 years. This study highlights the need for more effective treatments for a patient population with a significant level of unmet need.