The prevalence of oropharyngeal cancer is increasing in the Western world, and human papillomavirus (HPV) is believed to play a role in this development. Patients with HPV-positive oropharyngeal cancer differ significantly from patients with HPV-negative cancer. They may present solely with a small cervical metastasis and thus undergo an extensive diagnostic workup. Treatment modalities include radiotherapy often in combination with chemotherapy. However, new surgical advances are now possible. In this review we discuss the changing epidemiology, virology, symptomatology and different treatment modalities.