The aim of this cross-sectional survey was to ask patients about the financial burden of having head and neck cancer, and to explore its relation with health-related quality of life (HRQoL). In the Mersey region 447/752 eligible patients (59%) responded to the questionnaire. There was no obvious response bias. The most notable financial costs of head and neck cancer that were a moderate or large burden to patients were petrol (25%, 112), home heating (24%, 108), change in the type of food (21%, 95), and loss of earnings (20%, 88). During the previous week 15% (63/423) had lost a moderate or large amount of income because of their medical condition. In terms of taking care of their financial needs, 10% (40) were moderately dissatisfied and 15% (61) very dissatisfied. Patients with worse physical and social emotional functioning experienced more notable financial burden, more difficult life circumstances in the past month and greater financial difficulty and loss in income due to their condition in the previous week, more dissatisfaction with how well they took care of their own financial needs and were more likely to have sought statutory benefits. Cancer of the head and neck has a serious impact on financial aspects of patients’ lives and seems to be associated with a poor HRQoL. Multidisciplinary teams can do much more to address the cost of having treatment by recognising need earlier, and giving advice and access to appropriate benefits.