Abstract Neuroendocrine carcinomas of the head and neck are infrequent. They appear as original tumours in this area, or more frequently as lymph node metastasis, while some of them are of unknown origin. We describe four cases diagnosed by pathological study of neuroendocrine carcinomas in the head and neck area since 2002. All of the cases were male, with a mean age of 59 years. In the two primary cases, the tumours were located inside the maxillary sinus and larynx; the other two were cases of cervical metastasis originating outside of the head and neck area. Three of them died in less than 18 months. We emphasise the wide distribution this kind of tumours has and the varying forms of associating; these factors make it difficult to join the symptomatology into a single group, as well as to arrive at the diagnosis and to carry out treatment.