The case histories of 8,956 patients treated for primary malignancies arising in the lung, head and neck, or both were reviewed. Eighty-five (21%) of 406 patients with primary bronchogenic malignancy associated with neoplasms at other sites had head and neck malignancies; they comprise 0.9% of the total and form the basis of this report. The head and neck malignancy preceded bronchogenic carcinoma in 70 patients; bronchogenic carcinoma occurred first in 8 patients; and malignancies occurred in both sites synchronously in 7 patients. Case histories and tabular analysis of pathology, social history, time interval between lesions, treatment, and survival are presented. A strong association between heavy cigarette smoking, alcoholism, and multicentric respiratory tract malignancies is noted. Critical analysis supports aggressive treatment of each lesion as a separate solitary primary malignancy.