Performance status (PS) is a key factor in the selection of treatment in head and neck cancer patients (HNC).There is a probability in the development of an unfavorable PS with HNC advancing stages. This retrospectivestudy was done on data of patients registered during the period from January 2010 to December 2012 at acancer registry in the North Eastern India. PS was recorded according to the WHO scale. Multinomial logisticregression analysis was conducted to assess the probability of poor performance status with advancing stage.Out of 3,593 patients, there were 78.9% (2,836) males and 21.1% (757) females. Average PS0 was seen in 57.4%of all HNCs, less than 1% of all cases in HNCs with poor PS3-4 except in cases with thyroid, parotid and noseand PNS cancers, 0.7% stage IV (±M1) HNC with PS4, favorable PS0-1 was seen in 84% to 100% of cases,RR=57.1 (CI=21.2-154.1) in M1 for PS4 and with advancing stages the probability of worsening of PS0 to PS4was 3 times (P=0.021, 95% CI= 1.187-8.474). In HNC, the majority of patients presents with a favorable PS0-1 with different odds of worsening of PS with advancing stages and the presence of metastasis in stage IV issignificantly associated with a poor PS.