Aims: Māori experience significant inequities in head and neck cancer (HNC), characterised by younger age at presentation, more advanced disease stage, and poorer survival outcome. This study aimed to compare clinical characteristic and treatment timeline for Māori and non- Māori patients undergoing neck dissection. Methodology: A retrospective cohort study was conducted at a New Zealand tertiary Otorhinolaryngology centre. The study included all patients who underwent neck dissections under the Waikato Hospital ORL service from January 1, 2023, to December 31, 2025. Data collected included demographics, comorbidities, tumour characteristics, treatment modalities, nodal yield and critical treatment windows: referral to surgery and surgery-to-adjuvant radiotherapy. Statistical analysis was performed using Fisher's exact test and chi square. Results: Seventy-six patients (17 Māori and 59 Non-Māori) undergoing 88 neck dissections were included. Māori were diagnosed younger (mean 63.9 vs. 66.3 years) and presented with more advanced disease (23.5% with T3/T4). The most common primary site among Māori was the oral cavity (47%) with squamous cell carcinoma as the predominant histology (70.5%). A significant disparity was noted in surgical access: the median time from referral to surgery was 28% longer for Māori patients (110 days for Māori compared to 86 days in non-Māori). Conversely, this trend is reversed in the post-operative phase; the time from surgery to adjuvant radiotherapy was shorter for Māori (89 days vs. 114.6 days in non-Māori). No statistically significant difference was noted in nodal yield between groups. Conclusion: This study demonstrates disparities at age of diagnosis, disease stage and access to surgical care. While hospital-based treatment can achieve equity, the systemic bottlenecks remain in the preoperative and referral phases for Māori patients. Addressing these pre-operative barriers is essential to improving oncological outcomes and achieving health equity.