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Aim: To compare Australian and New Zealand (NZ) rates of referral to hyperbaric units for patients with, or at risk of developing mandibular or maxillary osteoradionecrosis (ORN) due to a history of radiotherapy for oro-pharyngeal cancer. Method: Relevant patient treatment data from all hyperbaric units in Australia and NZ were collated and analysed. Results: The rate of referral to hyperbaric units in Australia for treatment or prophylaxis of patients with, or at risk of orofacial ORN, was 1.7 times the rate of referral in NZ. Within Australia, there was a greater than three-fold interstate variation. Conclusion: There is a significant referral rate difference both within Australia and between Australia and NZ for hyperbaric oxygen therapy for oro-facial ORN. Possible reasons for this difference include access to funding, logistical difficulties, clinician preference for an alternative treatment and clinician attitudes to hyperbaric oxygen. [ABSTRACT FROM AUTHOR]