The management of the cervical lymph nodes is an integral part of the overall treatment of the oral cavity malignancies. The indications and uses of the various types of neck dissections and pre and postoperative radiotherapy has been a subject of much debate. Based on the results of the present study and the literature available with us, we can conclude that, Dissemination of metastatic cancer to regional lymph nodes from primary sites in the upper aerodigestive tract occurs in a predictable and sequential pattern. For primary tumours in the oral cavity, the regional lymph nodes at the highest risk for early dissemination by metastatic cancer (first echelon nodes) are limited to levels 1,2 and 3, i.e., within the supraomohyoid triangle of neck. Skip metastasis to levels 4 and 5 in the absence of metastasis at levels 1,2 or 3 is very rare.