Background On computed tomography, the Head and Neck Imaging Reporting and Data System (NI-RADS) is a standardized reporting structure for categorization the degree of suspicion for recurrent head and neck malignancies.Purpose The purpose of our study was to analyze the efficacy of the NI-RADS ratingscale and criteria for contrast-enhanced computed tomography (CECT) alone inpredicting the local and regional recurrence of malignancies after chemoradiotherapy. Material and Methods: CECT of the patients with head and neck cancers receivingradiotherapy and concurrent chemotherapy as a primary treatment was obtained3 months after the completion of radiotherapy and NI-RADS scoring was done usingcomponents of Response Evaluation Criteria in Solid Tumors (RECIST 1.1) criteria. Theirmanagement was directed according to the recommendations based on their NI-RADSscore.Results: This research included 30 patients with squamous cell carcinoma of the neck. The outcome of the biopsy or the follow-up plan, as advised by the NI-RADS rating scale, determined whether the recurrent illness was positive or negative. Pathology confirmed recurrence at the original tumor site in 15 patients. Disease persistence rates for the primary tumor location were 4% for NI-RADS 1, 24% for NI-RADS 2, and 80% for NI-RADS 3. There was recurrent lymph nodal disease in five individuals. According to NI-RADS categories 1, 2, and 3 for lymph nodal assessment, the recurrence rates of nodal disease were 5.3, 25, and 66.7%, respectively.Conclusion: For patients with neck malignancies, CECT alone may be used to give the NI-RADS rating scale using RECIST 1.1 criteria to determine whether recurrent tumors will develop or not.