Head and neck cancers (HNCs) are becoming more common, thereby gaining greater attention within the medical community. This retrospective trend analysis examined geographical access to HNC clinical trials in the United States from 2005 to 2024, utilizing Census data and the Haversine formula. A search of ClinicalTrials.gov identified 23,450 trial sites, with 18,394 initiated before 2020. Although linear regression revealed a slight annual increase in trial initiation (37.947 trials/year, R² = 0.014, P = .625), most observed trends did not reach statistical significance. The proportion of the population residing within 1 mile of the trials saw a minor increase (0.328%/year, R² = 0.178, P = .064). Accessibility remained consistent throughout the COVID-19 pandemic, despite a decline in trial initiation during 2020. Enhancing access to trials, especially for marginalized populations, could improve patient engagement and clinical results.