Objective: Schwannomas in the head and neck region are relatively rare, and there is limited large-sample surgical experience available. This study aims to retrospectively analyze the clinical data of patients who underwent surgical treatment for head and neck schwannomas, providing scientifically grounded references for clinical practice to optimize treatment strategies and improve therapeutic outcomes. Methods: Head and neck schwannomas treated at Hunan Cancer Hospital between December 2019 and July 2025 were selected as the study subjects. The included cases met the following criteria: preoperative imaging indicating a space-occupying lesion in the head and neck region, complete clinical data, and postoperative pathological confirmation of schwannoma. This study summarized and analyzed the surgical techniques, clinical efficacy, and follow-up results of these schwannoma patients. Patients who underwent endoscopic treatment were excluded. Results: All 87 schwannoma patients had lesions located in the head and neck region. All surgeries were successfully completed, with a 100% total resection rate. The operative duration ranged from 27 to 460 minutes, and intraoperative blood loss varied between 20 and 500 mL. During the follow-up period of 8 to 66 months, recurrence was observed in 3 patients, with 1 case experiencing repeated recurrence. Additionally, 1 patient developed secondary lung cancer, and 12 patients (13.8%) exhibited symptoms of nerve injury. Over the course of follow-up, these symptoms improved, and no patient deaths occurred. Conclusion: The use of microsurgical techniques during schwannoma surgery can effectively preserve nerve function and reduce complications. Combining intraoperative neurophysiological monitoring can enhance the safety of the surgery.