<p>Oral squamous cell carcinoma (OSCC), particularly squamous cell carcinoma of the oral tongue (OTSCC), poses significant challenges due to its aggressive nature and high incidence rates. Surgical intervention, such as glossectomy, is the primary treatment modality for resectable OTSCC, often supplemented with adjuvant therapies to improve outcomes. This study systematically evaluates oncological outcomes, survival rates, and failure patterns in patients with resectable OTSCC treated with glossectomy. The study aims to identify prognostic factors, assess treatment efficacy, and understand reasons for locoregional recurrence and poor survival outcomes. A retrospective analysis of 56 patients who underwent glossectomy for OTSCC between 2010 and 2021 at King Abdullah Medical City was conducted. Data on demographics, clinical characteristics, treatment modalities, and oncological outcomes were collected and analyzed. Statistical analyses including Kaplan-Meier survival curves and Cox regression were employed to evaluate survival and recurrence. The cohort predominantly included older adults with early-stage OTSCC. Surgical interventions varied, with a significant proportion receiving adjuvant therapies. Oncological outcomes showed a 5-year overall survival rate of 35.7%, with notable rates of locoregional recurrence. Pathological staging, lymphovascular invasion, and perineural invasion emerged as significant predictors of survival and recurrence. Despite advancements in treatment strategies, OTSCC remains challenging with modest survival rates and frequent recurrence. Early detection, comprehensive staging, and tailored treatment approaches are crucial for improving patient outcomes and quality of life.</p>