BACKGROUND To evaluate the care and outcomes for patients presenting with floor of mouth (FOM) cancers. METHODS In this Ethics-approved audit, all eligible patients were evaluated with eligibility defined as having a squamous cell carcinoma originating in the FOM. Patient, disease and treatment factors were defined. Primary end points were ultimate local/regional control and cancer-specific survival. These were analysed according to the Kaplan-Meier method. The log-rank test was used to determine statistical significance between survival curves. Multivariate analysis was conducted using Cox regression. RESULTS A total of 157 patients were eligible for analysis, 76% males and 24% females, with 38 (24%) having a prior diagnosis of cancer. Surgery was performed in 126 patients (54 with pre/postoperative radiotherapy), radiotherapy only in 30 patients and chemotherapy only in 1 patient. Surgery had the best local control (85%), with 23/30 (77%) patients having radiotherapy failing locally. Ultimate regional control was achieved in 89% of patients, while new primaries occurred in 45 (29%) CONCLUSIONS Surgery remains an essential component of the treatment of patients with FOM cancers, with a high likelihood of other cancers developing.