Surgical site infection after open and endoscopic head and neck surgery represents an enormous physical, psychosocial, and financial burden for patients. Despite major advances in ablative and reconstructive head and neck surgery, surgical site infection remains a central problem with rates exceeding 15% in some patient cohorts. This presentation will review the history and current evidence supporting antiseptic techniques in head and neck surgery, for both endoscopic and open approaches, and for both benign and malignant diseases. This will include the range of pre- and intra-operative topical preparations, systemic prophylactic antibiotics, and critical elements of post-operative care. Future directions in preventing surgical site infection will be discussed including recent multi-institutional and clinical trial efforts led by members of the AHNS microvascular and head and neck surgery committees. This topic will be handled through a panel presentation that will include both didactic and interactive components. A brief expert lecture on both open and endoscopic perioperative antisepsis will be presented (10 min each, 20 min total) followed by a moderated 40 min, four case presentation with expert input and interactive polling through the audience-response system. Expert panelists will include a combination of junior and senior faculty.