Management of early tongue cancer is very challenging. A single surgical modality is the gold standard that ensures a high disease-free percentage. Clinical underestimation, however, can bring about a more elevated risk of relapses and poor prognosis. Surgical technique for early stage is type I or II glossectomy, both in transoral approach. The type I can also be defined as a mucosectomy of the tongue for cT1 or even premalignant lesions. Type II is indicated for more extended tumors, cT1-2 tumor that involves intrinsic muscle. Surgical technique comprehends the removal of oral portion of hyoglossus muscle along with sublingual gland for oncological reasons. This chapter gives a detailed account of surgical planning for early-stage tongue tumors, followed by step-by-step cadaveric dissection with figure explanation.