A retrospective review is presented of 76 patients, referred to the National Cancer Center Hospital, Tokyo, who underwent surgical management for squamous cell carcinoma of the floor of the mouth during the period March, 1969, to May, 1988. Of the 76 patients, 34 (45%) were treated by surgery alone, 19 (25%) by cryosurgery and 23 (30%) by a combination of surgery and another treatment modality, either irradiation (22 patients) or chemotherapy (one patient). Fifty-three percent of the patients had stage III or IV disease. Twenty-two patients (29%) developed recurrent disease during follow-up. Eighty-five percent of the treatment failures were identified within 24 months of treatment. The most common site of recurrence, seen in 14 out of 22 cases, was the neck. The actuarial five-year survivals for patients were: stage I disease, 96%; stage II, 79%; stage III, 66%; stage IV, 49%. Recent technical advances, allowing extensive resection and reconstruction in the surgical management of this kind of tumor, have improved the prognosis even for patients with advanced disease.