The treatment failures of oral squamous cell carcinoma (OSCC) are mostly local and regional recurrences. The aim was to estimate the prognosis of patients with recurrent OSCC through the prognostic staging system. We reviewed 81 patients with recurrent OSCC from April 1, 1999, to April 1, 2005. The independent prognostic factors for the patients with recurrent OSCC were identified by the univariate and multivariate Cox regression analyses. Then, to develop a prognostic staging system, and according to this staging system, the patients with recurrent OSCC were divided to 4 stages. By the Kaplan-Meier and log-rank statistical analyses, we found that the survival rate of patients with recurrent OSCC was significantly different at the different developmental stages. The primary TNM cancer stage before initial treatment, the extent of recurrence, and the recurrent tumor size are the independent prognostic factors for the patients with recurrent OSCC. Through this clinical study, the earlier-stage cases (stages I and II) for the patients with recurrent OSCC had a significantly better survival outcome compared with the advanced-stage cases (stages III and IV), and at the early recurrent stage, the salvage surgery represented a reliable and feasible treatment method.