Oral cavity cancer ranks sixth in cancer incidence in Taiwan, and it is the most common malignancy diagnosed in Taiwanese men aged between 30 and 50 years. Despite recent declines in high risk habits, the incidence of oral cavity cancer in Taiwan is still increasing with more than 5000 new cases diagnosed in 2011. Currently, the main treatment modality for oral cavity cancer is surgical excision, either with or without adjuvant therapy. The National Comprehensive Cancer Network (NCCN) guideline is the most widely accepted guideline for head and neck cancer including oral cavity cancer. However, NCCN guidelines do not specify a definite treatment for T4b oral cavity cancer, which is not uncommon in Taiwan. In this study, we investigated current oral cavity cancer treatments in Taiwan, compared these treatments with those stipulated by the NCCN guideline, and made recommendations on the most optimal treatment for Taiwan patients.