Background: The immune response has an important role in cancer progression. At the same time, anti tumor effect of the immune response has been speculated to cause destruction of cancer cells. Recent studies have highlighted the significance of tumor infiltrating lymphocytes TILs in different cancers. The International Immuno Oncology Biomarkers Working Group has in 2017 published a practical review proposing a standardized method to assess TILs in the routine hematoxylin and eosin HE stained sections.Aims objectives: To discuss the association between TILs and survival in head and neck squamous cell carcinoma HNSCC .Material and methods: We review recent studies having assessed TILs in HNSCC and showing that tumors having low TILs associate significantly with worse survival.Results: These findings underline that HNSCC cases with low TILs might benefit from multimodality treatment and might be indicated to receive immunotherapy.Conclusions: The evaluation of TILs using routine HE stained sections is practical and can be considered in assessment of antitumor activity.Significance: Here, we highlight the impact of overall assessment of TILs using the routine HE stained specimens in HNSCC....