**1. Introduction**

HPV is currently a well-recognized and emerging risk factor for head and neck squamous cell carcinoma. HPV associated oropharyngeal carcinoma have distinct clinical behavior and outcome. This led to a paradigm shift in the research and trend towards De-escalating treatment strategies. The rationale of these trials is to prove that the de-intensified treatment modality has same efficacy with less morbidity compared to standard of treatment. This chapter tries to elaborate on the epidemiology, oncogenesis, testing for HPV, treatment approaches and different clinical trials addressing the issue.
