Pain is one of the most common presenting complaints in patients diagnosed with advanced head and neck cancers occurring in about thirds of the patients at the time when they are first diagnosed in the initial stages of the disease process. Among these, about half of the patients die within five years from the day of diagnosis while the ones who survive are left with significant morbidity. Cancer-associated pain is one of the most common situations difficult to manage in a significant number of head and neck cancer affected patients. Despite all the advances in the understanding, diagnosis and the treatment modalities available for the treatment of cancer associated pain, a significant fraction of patients are left to bear considerable pain owing to the lack of an exact criteria for the evaluation of pain, reluctance of the health care providers regarding the use of opioids and the reservation of advanced treatment modalities for the management of pain only in its advanced or terminal stages. The aim of this paper is to highlight the varying aetiologies and patho-physiologies of the head and neck cancer associated pain and more than that the need for an effective pain management protocol to be followed in the management of the variable expressions of this type of pain in patients who are left to suffer agony of pain despite the availability of voluminous literature regarding the understanding of cancer associated pain.