Our objective is to discuss the current controversies that surround the management of retromolar trigone (RMT) cancer. We conducted this literature review to discuss trigone cancer. RTM and anterior pillar cancers should be studied separately. Preoperative clinical and radiographic assessments need to be further investigated to establish their reliability at predicting bone invasion. In the absence of suspicion of bone invasion, surgery and radiotherapy seem to give similar results, but recent reports indicate a greater benefit if they are used in combination. Some authors have advocated systematic segmental resection for all RMT cancers but marginal mandibulectomy is a reasonable option in selected cases. Standard treatment for RMT cancers with N0 necks is selective neck dissection or radiation therapy, depending on the modality of treatment of the primary. Allowing a better understanding of the evolution of RMT cancer and its response to different treatment modalities requires efforts to report different institutional experience with this rare tumor.