OBJECTIVE: To evaluate the rate of neck recurrence in patients with early stage (T1/T2) squamous cell carcinoma (SCC) of the oral cavity with clinically negative necks (cN0), and to compare the rate among patients who have undergone sentinel lymph node biopsy (SLNB) and those who have undergone elective neck dissection (END). METHODS: Clinical comparisons were made of 2 cohorts of patients with early-stage oral cancer who were tested for primary tumor resection and underwent SLNB without subsequent END or who underwent primary tumor resection with END. Comparisons were made by matched pair analysis. RESULTS: The current study included 52 patients with early-stage oral cancer, 30 of whom underwent SLNB and 22 who underwent END (control group). The neck recurrence rate was similar in both groups without any significant differences. CONCLUSION: SLNB is a new option for the treatment of early-stage SCC of oral cavity. Neck recurrence rates were similar between groups of patients who underwent SLNB and END. KEYWORDS: sentinel lymph node biopsy, lymphatic metastasis, squamous cell carcinoma, oral cavity, neck dissection.