Aim: Geographic barriers are commonly assumed to contribute to delays in cancer diagnosis and treatment. This study investigates the impact of travel distance on the presentation and survival outcomes in patients with oropharyngeal squamous cell carcinoma (OPSCC). Methodology: A retrospective review was conducted on 180 patients with OPSCC treated at St Vincent’s Hospital Melbourne between 2017 and 2022. Patients were classified as urban or regional based on median distance to hospital (≤31.4 km vs >31.4 km). Outcomes included stage at diagnosis, time from diagnosis to treatment, and overall and disease-specific survival. Statistical analyses included chi-square tests, Kaplan-Meier curves, and Cox proportional hazards regression. Results:No statistically significant differences were observed between urban and regional groups in T stage (p=0.41), N stage (p=0.71), overall stage (p=0.52), p16 status (p=0.55), or smoking status (p=0.40). A clinical trend toward higher staging in regional patients was noted. Median time to treatment was 29 days for urban patients vs. 32.5 days for regional patients (p=0.27). Delays >90 days occurred only in regional patients (5.7%, n=5/88) and there was a trend toward longer treatment delays in regional patients compared with urban patients (p=0.06). Multivariable survival analyses showed no significant differences in overall or disease-specific survival across any timepoint or remoteness classification. Conclusion:While travel distance was not associated with later stage at diagnosis or poorer survival, regional patients were more likely to experience prolonged treatment delays. This suggests that high volume tertiary referral head and neck oncology services help to reduce barriers to head and neck cancer treatment. Treatment timeliness remains a point of vulnerability highlighting the need for targeted support to reduce delays in regional patients, particularly those exceeding 90 days.