Records of 100 consecutive cases of carcinoma of the buccal mucosa treated in our institute between January 2000 and December 2003 were analyzed for clinical presentation, patterns of care, disease-free survival (DFS) and prognostic factors. There were 75 males and 25 females. The mean age was 50 years. Ninety five gave a history of abuse of oral tobacco products. Only 20 patients were in Stage I or II. Sixty one patients had Stage IV disease. Sixty six patients were treated with radical intent while 34 were suitable only for palliative radiation. The 2-year DFS for the entire group was 47.94%. All failures occurred by 12 months. However, the 2-year DFS in radically treated patients was 76.4%. On univariate analysis, late overall stage, T3/T4 disease, node positivity and palliative treatment were significant poor prognostic factors. On multivariate analysis, T3/T4 disease and palliative treatment were independent poor prognostic factors. Early detection can improve outcomes considerably in this disease.