Introduction Limited evidence supports the benefit of chemoradiotherapy for locally advanced head and neck cancer (LA-HNSCC) in elderly patients. Further evidence is needed to support the use of combined modality approaches in elderly patients. Methods We performed a single institution retrospective review of elderly patients treated with chemoradiotherapy for LA-HNSCC. Patients >70 years of age who received cisplatin or cetuximab alongside radiotherapy for LA-HNSCC in the definitive or adjuvant setting between the sampled years of 2017-2020 were included. Primary outcomes were overall (OS) and progression free survival (PFS) in total population and for cisplatin and cetuximab. Secondary outcomes were OS based on cumulative dose of cisplatin and toxicity outcomes. Univariate regression was performed for survival analyses and cox proportional hazards regression models estimated the hazard ratios (HR). Multivariable regression estimated the HR associated with cisplatin vs cetuximab, adjusted for variables of age, functional status and comorbidities. Results One hundred and eleven elderly patients received adjuvant and definitive chemoradiotherapy (94 definitive and 17 adjuvant). The 5-year OS estimate was 59% for all patients and the 5-year PFS was 52% for all patients. The 5-year OS estimate was 66% for cisplatin and 45% for cetuximab (HR 0.53, p=0.02). 5-year PFS estimate was 60% for cisplatin and 32% for the cetuximab cohort (HR 0.28, p=0.001). 5-year OS estimate was 68% for cisplatin cumulative dose ≥200mg/m2 and 59% for patients who received <200mg/m2 of cisplatin (HR 0.58, p= 0.20). After multivariate analysis, the HR for OS was 0.95 (p=0.90) for cisplatin vs cetuximab. Grade 3-4 toxicities occurred in 38% and 64% of the cisplatin and cetuximab cohorts, respectively. Conclusion Carefully selected robust elderly patients with LA-HNSCC treated with chemoradiotherapy have comparable outcomes to younger patients after treatment for locally advanced head and neck cancer.