Cancers of the oral cavity make up 3-4% of all cancers, being in eighth place in men and eleventh in women when the cancer is caused by smoking and alcohol misuse. In this study we recorded all oral cancers in Enugu, eastern Nigeria over the 6-year period from 1998 to 2003. We reviewed all patients who had a diagnosis of invasive oral cancer during this period from notes kept in the Records Department of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. Carcinoma-in-situ, lymphoma, and leukaemia were not included. All cases were categorised by the site of the turnout and the age and sex of the patient. Eighty one cases of oral cancer were recorded during that period, accounting for 2.7% of all cancers. Forty-eight men and thirty-three women were affected, and the most common site was other sites of the oral cavity (28, 35%), followed by the tongue (24, 30%), floor of the mouth (17, 21%) and finally the lip (12, 15%). They were all advanced at the time of presentation. The patients gave no history of alcohol or tobacco misuse, and their conditions should be seen in terms of chronic illnesses, malnutrition, poverty, and ignorance. We need an urgent awareness campaign, and programmes for the prevention and early detection of oral cancer, in Nigeria. (c) 2006 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.