TObjective To assess the impact of close or positive surgical margins on the outcome, and to determine whether margin status infl uence the recurrence rate and the overall survival for patients with head and neck cancers.Methods Records from 1996 to 2001 of 413 patients with primary head and neck squamous cell carcinoma (SCC) treated with surgery as the fi rst line treatment were analysed. Of these patients, 82 were eligible for the study. Patients were followed up for 5years.Results Patients with margins between 5-10 mm had 50% recurrence rate (RR), those with surgical margins between 1-5 mm had RR of 59% and those with positive surgical margins had RR of 90% (P=0.004). The 5-year survival rates were 54%, 39% and 10%, respectively (P=0.002).Conclusions Unsatisfactory surgical margin is an independent risk factor for recurrence free survival as well as overall survival regardless of the other tumor and patient characteristics.