Aims Best practice management of oropharyngeal squamous cell carcinoma (OPSCC) in the elderly is complex. Currently there is limited evidence regarding transoral robotic surgery (TORS) in this cohort with respect to post-operative and oncological outcomes. The aim of this research is to review the surgical, oncological and survival outcomes of patients aged 70 and over compared to their younger counterparts, undergoing TORS with or without adjuvant therapy. Methodology A retrospective cohort study was conducted comparing surgical outcomes between TORS patients aged ≥70 years versus <70 years. Paper and electronic records were accessed for data collection of patient’s pre-operative health status, pathological diagnosis, admission details, adjuvant therapy and follow-up information. Statistical analysis of the surgical, functional, oncological and survival outcomes was performed using SAS On Demand for Academics (SAS Institute Inc. 2024 Version 9.4: Cary, NC, USA). Results 167 patients were identified to have undergone a TORS procedure for curative oncological treatment of OPSCC at the Royal Adelaide Hospital between 2013 and 2021 and met inclusion criteria. Our data suggests that the older population have reasonable surgical, functional and oncological outcomes. Age was not associated with delay in oral intake post-surgery (P value 0.8907) nor with disease recurrence (P value 0.2811). Patients ≥70 years, however, had greater overall and surgical complication risk (P value =0.0002, P value=0.0007). Greater comorbidity status was also associated with greater overall complication risk (P value 0.0476). Conclusion Conclusions may propose that comorbidity and frailty status are better indicators for predicting surgical and oncological outcomes rather than age. The findings are significant in enhancing evidence-based treatment recommendations, with greater confidence in outcome predictability for elderly patients given comparable functional and surgical outcomes and acceptable survival outcomes.