We report a case of recurrent and metastatic oral squamous cell carcinoma successfully treated with second-line combination chemotherapy of cisplatin and gemcitabine. A 62-year-old woman, who had previously been treated with surgery and chemoradiation, was referred to our department for systemic metastasis of oral cancer. She had received a combination regimen of cisplatin and 5-fluorouracil against locoregional recurrence. Systemic evaluation revealed metastasis to the lungs, liver and bones. Three cycles of a four-week regimen of combination chemotherapy including cisplatin and gemcitabine resulted in remarkable reduction of the pulmonary and liver metastatic tumors despite frequent neutropenia. Combination chemotherapy of gemcitabine and cisplatin was highly effective in this case, which recurred after a cisplatin-containing regimen. Gemcitabine seems promising and active for head and neck cancer treatment.