Objective This study aims to retrospectively analyze the clinical data of patients who underwent surgical treatment for head and neck schwannomas, with the goal of providing scientific evidence for clinical practice, optimizing treatment strategies, and improving therapeutic outcomes. Methods Head and neck schwannomas treated at Hunan Cancer Hospital between December 2019 and July 2025 were selected as the study subjects. The included cases met the following criteria: preoperative imaging indicating a space-occupying lesion in the head and neck region, complete clinical data, and postoperative pathological confirmation of schwannoma. Patients who underwent endoscopic treatment were excluded. The surgical techniques, clinical efficacy, and follow-up results of these patients were summarized and analyzed. Results A total of 87 patients with schwannomas were included, and all lesions were located in the head and neck. All surgeries were successfully completed, with a total resection rate of 100%. The operation time ranged from 27 to 460 minutes, and intraoperative blood loss varied between 20 and 500 mL. During the follow-up period of 8 to 66 months, recurrence was observed in 3 patients, with one relapsed multiple times. Additionally, one patient developed secondary lung cancer, and 12 patients (13.8%) presented with neurological deficits. The neurological function gradually improved during the follow-up period, and no patient died. Conclusions The use of microsurgical techniques during schwannoma surgery, when necessary, can effectively preserve nerve function and reduce complications. The combination of intraoperative neurophysiological monitoring can enhance the safety of the surgery.