The aim of this study is to describe the clinical profile, treatment, patterns of failure and factors predictive for recurrence in patients with carcinoma tongue.Methods: 643 patients who underwent surgery for squamous cell carcinoma of the tongue atRegional Cancer Centre, Trivandrum, India from April 2002 to December 2007 wereretrospectively reviewed. The clinical profile, treatment details, pathology findings, adjuvanttreatment and pattern of recurrences which developed on follow up were analyzed. Comparisons of survival time between strata ofcategorical variables were made with the Kaplan-Meier method and log-rank test.Results: There were 405 men and 238 women. Mean age of the study group was 56years.Median follow up was 43 months and the maximal follow up was 103 months. 169 patientswere stage I, 227 were stage II, 156 were stage III and 91 were in stage IV disease. 490 patients had a neck dissection on the ipsilateral side while 15 patients also had a contralateral neck dissection. 92% of tumors were well to moderately differentiated squamous cell carcinomas. 107 patients had a close margin of excision, 79 had perineural infiltration, 15 had dysplasia at margins and 20 had extra capsular spread.186 patients (29%) had pathological node positivity. Lower levels of neck nodes (level 4 and 5) were involved in 8 patients (1.2%) 291 patients received post operative radiotherapy. On follow up, 74 patients(11.5%) recurred at the primary site, while 49 patients recurred in the neck nodes.30.2%females and 20.4% males had loco regional recurrence, 11 patients had distant metastasisand 30 patients developed a second primary during the follow up. The study group had 71.2% 5 year disease free survivalConclusion: On univariate analysis significant factors for recurrence were female sex, Tstage, composite staging, extracpsular spread and dysplasia at the resected margins and onmultivariate analysis sex and extra capsular spread were found to be significant