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To date, only a few contributions have examined the impact of health care systems on social inequalities in health. While it is difficult to uncover and document the presence of inequalities within curative care, a converging amount of empirical evidence points to the role and importance of this issue, which is therefore not to be neglected. Drawing on observations of multidisciplinary oncology meetings, the purpose of this article is to discuss how the health care system contributes to the (re)production of health inequalities by exploring the decision-making system underlying the biomedical management of patients suffering from head and neck cancer. Its main goal is to contribute to the understanding of the social dimension of medical decision-making, focusing in particular on whether and to what extent extra-clinical criteria account for the prescription of different treatments.