Most patients receiving radiation therapy to the head and neck region will experience some type of oral complication. Xerostomia is one of the most severe symptoms that patients experience and may become a lifelong problem. This article reviews normal salivary function, effects of radiation therapy on oral mucosa, impact of xerostomia on quality of life, and current treatment strategies used to manage this debilitating side effect. Oncology nurses can have a significant impact on patient outcomes through diligent assessment and ongoing education regarding symptom management.