Abstract Objective: This study aims to investigate the factors that lead to poor compliance in initiating the treatment in patients with newly diagnosed head and neck cancers. Design: Retrospective cohort study Particpants: Data from a total of 271 patients were retrieved and analyzed. After excluding patients with (1) multiple cancers (2) inconclusive diagnoses, (3) rare primary cancer sites, such as the nasal cavity, paranasal sinuses, or salivary glands and (4) primary site unknown, a total of 194 patients were included in this study. Main outcome measures: The variables included in the analysis were age, gender, primary cancer site, T stage, N stage, M stage, overall stage (I-IV), patient’s residential distance, and the impact of COVID-19. Univariate and multivariate analyses were employed to evaluate the significance of these variables in regard to affecting the time to receiving on-time treatment based on the specialist’s suggestion. Results: Upon multivariate analysis, the primary site, stage, and residential distance were significantly associated with initial compliance (P<0.05). The impact of COVID-19 showing a borderline significance (p=0.137). Conclusion: The primary site, overall stage, patient living distance to the healthcare facility, and the impact of COVID-19 might affect the compliance of initiating a curative-intent treatment in patients with newly diagnosed head and neck cancers.