Objectives: The goal of this research was to determine the existence of the significant time differences in the identification of the recurrences and neck metastases in the patients surgically treated for the oral cavity cancer by comparing three postoperative follow up methods. The study included 397 patients surgically treated for oral and pharyngeal cancer in period from 1992 to 2008 at Department of Oral and Maxillofacial Surgery, Rijeka University Hospital Center. Patients and methods: The study included 397 patients surgically treated for oral and pharyngeal cancer in period from 1992 to 2008, divided into three groups based on the different postoperative follow up protocol. I have analyzed the patients who had local recurrences and/or neck metastases within 2 years after the operation. Data were collected at Department of Oral and Maxillofacial Surgery, Rijeka University Hospital Center; In the first group, which consisted of 92 patients who had local/or regional reccurances, the postoperative follow up was not systematic and it was conducted upon surgeon’s estimation, mainly every 2 to 3 months. The postoperative follow up included inspection and palpation of the oral cavity and neck. The second group consisted of 105 patients who had local/or regional reccurances, the postoperative follow up was systematic, once a month during the first postoperative year, and once in 2 months during the second postoperative year. Examination methods were inspection VIIand palpation, whereas neck ultrasound, CT and MRI were performed only when symptoms or physical examination indicated a possibility of recurrences and/or neck metastases. The third group consisted of 89 patients who had local/or regional reccurances, the postoperative follow up was systematic, once a month during the first postoperative year, and once in 2 months during the second postoperative year. Besides inspection and palpation every physical examination included neck ultrasound every 6 to 8 weeks during the first postoperative year and every 8 to 10 weeks during second postoperative year. If the suspected lymph nodes were found the neck ultrasound was followed by ultrasound-guided fine-needle aspiration citology (USg FNAC). CT and MRI were conducted if recurrence and neck metastases could not be proven by ultrasound and USg FNAC. Results:. Comparison between groups I and III in order to show stastically significant shorter length of time in detection of local recurrences and neck metastases in stadium III and IV of desease in favour of group III. Comparison between groups II and III in order to show stastically significant shorter length of time in detection of local recurrences and neck metastases in stadium IV of desease in favour of group III. Comparison between groups I and II, I and III and II and III in order to show stastically significant shorter length of time in detection neck metastases of contralateral side in stadium III of desease in favour of group II in the first comparision and in favour of group III in the second and third comparision. Comparison between groups I and III and II and III in order to show stastically significant shorter length of time in detection neck metastases of contralateral side in stadium IV of desease in favour of group III. VIIIConclusion: Comparison between groups I, II and III based on the type of surgical procedure was performed in order to show that differences in the length of time passed until recurrences and neck metastases were discovered are result of efficacy of used postoperative follow up methods, and not a result of different surgical treatments since all three types of surgical procedures were performed on almost equal proportions of the patients in all three groups. The results are even better if the usual, above mentioned methods are supplemented with regular ultrasound examinations combined with ultrasound guided fine needle aspiration citology. This study showed that combination of the classic follow up methods and ultrasound examination are superior over classical check up methods alone.