Objective To explore the biological behavior of the sarcomatoid carcinoma (SC) of head neck for improving the diagnosis, treatment and judgment of prognosis of the tumor. Methods Clinical data of the 11 cases of SC underwent operation in our department from 2005 to 2011 was analyzed retrospectively. Results Of all the patients, 10 were male and 1 was female with a male to female ratio of 10:1.The ages of the patients ranged from 33 to 71 with a median age of 51. The involved organs included larynx (2 cases), hypophargnx (5 cases) , paranasal sinuses (2 cases) , tongue base (1 case) , and temporal bone (1 case) . 8 cases were followed up and 3 were lost. The followup duration ranged from 7 to 55 months (median 15.5 months). 5 patients survived, 3 died and 3 got loss of followup. Two of the survivals have suspicious metastasis of the lung and cervical vertebra. Conclusion The final diagnosis of SC depends on the immunohistochemistry due to its specific biological behaviors and pathological characteristics. The surgical operation is the first choice for SC without metastasis. Radiotherapy is an important accessory treatment to operation，but its role in the prevention of local recurrence and metastasis still needs further investigation.