Preoperative elevation of serum C-reactive protein (CRP) has been demonstrated as a prognostic indicator in oesophageal, gastric and colorectal cancer. This study was designed to establish if elevated preoperative levels of serum CRP could predict the prognosis of patients treated with primary surgery for oral squamous cell carcinoma (SCC). Sixty patients with oral SCC who were treated by primary surgery and microvascular free flap reconstruction, were included in the study. The relation between preoperative levels of serum CRP, clinicopathological features and patient prognosis was determined. This study showed using bivariate analysis (p=0.003) and multivariate analysis (p<0.001) that a raised preoperative CRP was associated with worse overall survival. Tumour size and stage when combined with CRP levels increases the predictive power of this indicator.