Background:Verrucous carcinoma of the oral cavity (OVC) is an uncommon variant of oral squamous cell carcinoma (OSCC). The clinical presentation and surgical outcomes of OVC are unique; however, the management protocols for OVC are largely extrapolated from OSCC.Objectives:The aim is to study the clinical, histopathological demographics, and outcome of OVC at a tertiary care referral hospital in South India. To study the need for lymph node dissection and the role of adjuvant therapy for close resection margins.Materials and Methods:A retrospective review of all patients diagnosed to have OVC between January 2005 and April 2015 was undertaken. Data were collected from hospital records and telephonic interview when possible.Results:Thirty patients were diagnosed to have OVC. The most common site of the presentation was the buccal mucosa. Twenty-three patients had wide local excision of the primary tumor and seven patients had neck dissection as well. None of the patients who underwent neck dissection had node-positive disease pathologically. The margins were considered close in nine patients, only one of these patients received adjuvant radiation therapy; despite among the patients with close resection margins, there was no recurrence or disease-related mortality. Among the thirty patients, there was only one patient who had recurred locally and there was no disease associated mortality.Conclusions:OVC is a unique variant of OSCC which has a good prognosis. Routine lymphadenectomy can be avoided.