Aims Transoral robotic surgery (TORS) with neck dissection (ND) as single modality treatment of HPV-associated oropharyngeal cancer is now commonplace, yet no consensus exists on acceptable surgical margins. We aim to identify a safe acceptable resection margin from the first four years of data from a national robotic programme. Methodology Retrospective case series of patients with p16+ head and neck squamous cell carcinoma who received TORS as part of their management plan. Outcomes include primary tumour location, margins, burden of neck disease, adjuvant treatment, adverse outcomes and rate of locoregional recurrence. Results: 93 patients underwent TORS+/-ND (35 oropharyngectomy +/- contralateral tonsillectomy, 2 targeted tongue base resections and 56 diagnostic mucosectomy +/- tonsillectomy). 89 underwent ND. 31 patients received adjuvant chemoradiotherapy and 41 post-operative radiotherapy. 28 of these were due to pathological extra-nodal extension (ENE) 20 patients were treated via surgery as a single modality. Of these, 5 had no primary identified, 5 had tongue base primaries, 9 had tonsillar or glossotonsillar primaries and 1 had synchronous tongue base and tonsillar primaries. 9 recorded margins were 1mm or greater (average recorded margin 1.9mm (range 1 – 3.5mm); 6 patients had completion oropharyngectomies with no evidence of residual tumour. All had favourable neck disease. Average follow-up to date 25.0 months (2.7–55.6), one had recurrence of neck disease at 5 years (5.0%). Conclusions: Reliable prediction of ENE prior to TORS is important. Single modality TORS+ND in an appropriate patient cohort has excellent prognostic outcomes with low rates of locoregional recurrence. Narrower margins than previously considered and absence of demonstrable primary site following oropharyngeal clearance with clinical observation may reduce overall morbidity in this population. We recommend a staged neck dissection prior to TORS and an acceptable resection margin of 1mm.