not-yet-known not-yet-known not-yet-known unknown Background Head and neck cancers (HNCs) carry high risks of lymph node metastasis. Liver metastasis was usually evaluated in the initial tumor workup including positron emission tomography and liver sonography. The value of liver sonography was seldom investigated in the literature. Materials and Methods This retrospective study, analyzed data from patients newly diagnosed with head and neck squamous cell carcinomas, between 2018 and 2020. Patient demographics, tumor characteristics, preoperative investigations, and sonography findings related to liver were collected and analyzed. Results The study included 182 HNC patients with an average age of 56.66 years, of whom 93.9% were male. The most common primary tumor site was the oral cavity (67.0%), followed by the hypopharynx (12.6%) and oropharynx (11.5%). Tumor staging revealed that 55.5% of patients were at stage IV. Liver ultrasound findings showed that 22.5% of patients had liver nodules, 18.1% had liver cysts, and 2.7% had liver tumors. All the liver nodules and were stationary in follow-up CT. One hepatic cellular carcinoma was found. Child-Pugh classification indicated that 95.7% of patients were classified as Child A, and 4.3% as Child B. The study found a significant association between hepatitis B carrier status and liver cirrhosis (p=0.02). Conclusion: The frequency to find liver metastasis was low in our study. Liver cirrhosis and associated ascites especially in patients with chronic hepatitis were more important in HNC patients in initial treatment planning. Level of Evidence: 3