A clinicopathological study was made of 41 patients with squamous cell carcinoma of the upper gingiva. All patients had been treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University hospital, consisting of 15 men and 26 women, mean age 62 years, range 38-85 years. According to the T classification there were 8 cases with T1, 13 with T2, 10 with T3, and 10 with T4. Eleven patients were treated with surgery alone, 26 with both chemo-radiotherapy and surgery, and 4 with other combinations. Neck dissection was performed in 18 patients, among whom histopathological cervical lymph node metastasis was confirmed in 14. The most common site of metastasis was level II of the neck. There were no patients with level III, IV or V disease. The 5-year overall survival rate was 80.9%. With regard to tumor location, the 5-year overall survival rate was 100% in the group with the anterior region type, 88.5% in the molar region and 52.5% in the posterior region. There was a statistically significant difference in survival rate between the molar region group and the posterior region type group (p < 0.05). One patient died of primary recurrence, 1 died of cervical recurrence, 3 died of pulmonary metastasis, and 1 died of gastric cancer.