In a retrospective study of 54 patients with primary carcinoma of the tongue seen at the Montreal General Hospital from 1979 to 1984, the overall 2-year survival for those with stage I disease was 92%. Surgery alone was the initial treatment in 84% of these patients. Disease recurred in 36%. In stage II patients, 8 of 12 had surgery followed by radiotherapy; 37% had recurrent disease. Surgery alone was used in 4 of 12 and with recurrence in 3. Overall survival in stage II was 83% at 2 years. In cases of localized disease, the survival rate for surgery alone was not significantly different from that after surgery plus radiotherapy. Combined surgery plus radiotherapy might offer better regional control in stage II disease. Of 18 stage III patients, 7 were treated by surgery followed by radiotherapy; 3 died and 4 are disease free. All had commando procedures. Radiotherapy alone was used in seven and six of them had recurrences. Overall, the 2-year survival for stage III was 61%. Control of regional disease was achieved in 57% of those who had surgery plus radiotherapy as opposed to 39% overall. Stage IV patients had a 2-year survival of 10%. Nine of the 11 received chemotherapy followed by radiotherapy. This combination did not improve survival and most of these patients died within 1 year.