Oral mucositis is an unavoidable side effect of radiation therapy to the head and neck, which can compromise patient health and quality of life. This study investigates the effect of manuka honey on the extent of oral mucositis in head and neck patients in New Zealand. A total of 28 patients were recruited; 10 patients received standard care and 18 patients were given additional manuka honey. Honey was used three times a day; assessment included: extent of oral mucositis using a multi-site mucositis scoring system, weight and quality of life. The first six patients, randomised to the honey arm, used undiluted honey and pulled out in the first week because of extreme nausea, vomiting and stinging sensations in the mouth. The next 12 honey patients used a honey mouthwash (diluted 1:3). Six of these patients completed the trial and four more completed the first 4 weeks of the trial. Eight control patients completed the trial. In contrast to previous honey trials in Malaysia, Egypt, Iran and India, diluted manuka honey did not decrease the extent and onset of radiation-induced oral mucositis but did appear to ameliorate radiation-induced weight loss and increase quality of life in the absence of cisplatin chemotherapy.