Radiation induced malignancy is a late side effect of radiation therapy and can create a significant morbidity burden on patients. Radiation therapy has become partof the gold standard of treatment among patients diagnosed with HPV+ oropharyngeal cancers. In this study, we aimed to investigate the characteristics of head and neck second primary malignancies (SPMs) that can potentially be attributed to radiation therapy received as part of the treatment course for HPV+ oropharyngeal cancer.