Cervical lymph node metastasis influences the prognosis of tongue carcinoma. We retrospectively investigated 113 patients with stage I,II tongue carcinoma from 1986 to 2004 at our department. There were 26 patients who underwent elective neck dissection, of whom 8 had primary metastasis. On the other hand, there were 87 patients who did not undergo elective neck dissection. There were 26 patients who had late metastasis. Our results do not necessarily demonstrate a clear correlation between grade of malignancy and cervical lymph node metastasis. On the other hand, mode of invasion was a significant factor for cervical lymph node metastasis. The overall 5-year survival rate was 87.5% in primary metastasis and 57.7% in late metastasis. Among the patients who died, regional lymph node metastasis was seen in 6 patients, and 6 patients died as a result of distant metastasis. The incidence of extra-nodal spread was found only in patients with late metastasis. These results suggested that the mode of invasion and extra-nodal spread are the most important prognostic factors in cervical lymph node metastases. Further studies should assess the indication for neck dissection in cases of stage I,II tongue carcinoma.