Organ preservation treatment with radiotherapy with or without chemotherapy for oropharynx, hypopharynx and larynx cancer are associated with significant acute and long-term toxicities. With the emergence of human papillomavirus (HPV) as an etiologic factor associated primarily with oropharyngeal cancer, higher cure rates juxtaposed with therapy related morbidity has led to interest in de-escalated treatment strategies. Currently explored strategies by head and neck surgeons include reducing dose of radiotherapy in combination with less-invasive surgical approaches. One of the rapid emerging less-invasive surgery is trans-oral robotic surgery (TORS) with da-Vinci robotic surgical system. The unique characteristics of the system including 3-D high magnification endoscope, endo-wristed instruments with motion scaling & tremor filtration function enable surgeons to perform endoscopic surgery with more precision, dexterity, and control. After TORS in combination with neck dissection, radiotherapy could possibly be spared or de-escalated with good oncologic and functional outcomes. Our program summarizes the de-escalation of radiotherapy for cancers of oropharynx, hypopharynx and larynx by using TORS.