OBJECTIVE To analyze the clinical feature and treatment of head-neck malignant fibrous histiocytoma (MFH). METHODS A retrospective analysis on the clinical data of 28 cases of MFH were carried out, of which 9 were in the maxilla, 3 in the nasal cavity, 5 in the larynx, 3 in the parotid, 3 in the temporal bone, 1 in the hypothyroid, and 4 in the head and neck region. All of the cases underwent immune histochemistry: 4 cases of surgery alone, 23 cases of surgery followed by radiotherapy, and 1 case of radiotherapy alone. RESULTS Except 5 cases lost follow-up after 1 year, all the other cases were followed-up over 3 years, the survival rate for 1 or 3 years was respectively 96.4% (27/28) and 57.1% (16/28); 23 cases were followed up for 5 years, the survival rate was 26.1% (6/23). The recurrent rate in 3 years was 60.7% (17/28), with 1 to 7 times recurrence at a mean interval of 5.6 months. Twelve recurrent cases were adopted expanded resection of non-defined operation except 1 case with radiotherapy. CONCLUSIONS The diagnosis of MFH depends on the technology of immune histochemistry. Early diagnosis, expanded resection, and integrated therapy could reduce the recurrence and increase the survival rate; the recurrence could adopt expanded resection of non-defined operation to prolong the life.