Purpose: If certain adverse features are identified on histopathology, the National Comprehensive Cancer Network recommends adjuvant therapy for T0-2, N1 oropharyngeal SCC. The aim of this project is to review patients that have undergone surgery alone with evidence of adverse features on histopathology and the rates of recurrence. Methodology: This was conducted at Peter MacCallum Cancer Centre and Epworth Richmond, with patients included who had surgery between January 2014 – January 2022. A retrospective review was conducted identifying the rate of recurrence for T0-2, N1 oropharyngeal SCC with evidence of adverse features on histopathology, who were treated with surgical resection alone. Results: Thirteen patients (12 males and 1 female) were included in the study and at the time of surgery, the median age was 52.3 years and all underwent transoral robotic surgical resection and ipsilateral or bilateral neck dissection. There were no cases of recurrence during the follow-up period. Conclusion: Evidence for the treatment of more advanced oropharyngeal tumours remains based on smoking-related data. With the new epidemic of HPV-related oropharyngeal SCC we lack clear evidence of features guiding adjuvant treatment. This Australian series shows that good survival outcomes are possible with surgery alone even with historical adverse features. This can add some points for discussion within the multidisciplinary meeting. Further data is required before we can develop guidelines regarding safety of deintensification of treatment.