Background:The lung is the most common distant metastasis site from oral tongue cancer (OTC). However, there have been no reports on surgical resection results for pulmonary OTC metastases. The aim of this study was to evaluate surgical resection for OTC pulmonary metastases efficacy. Methods: Between 1977 and 2003, 23 OTC patients who developed 1 to 3 pulmonary metastases underwent metastasectomy. The clinicopathologic features and long-term outcomes were examined. Results: The 14 men and 9 women had a median age at the time of pulmonary metastasectomy of 56 (range; 28-72 years). All 23 patients had advanced squamous cell OTC with regional lymph node involvement or subsequent regional lymph node metastasis. The median tumor-free interval after the initial OTC treatment was 17 months (range: 1-165 months). Five patients had pneumonectomy, three bilobectomy, 13 lobectomy, and two wedge resection. Two patients underwent a second pulmonary metastasectomy. One patient continues to survive, without recurrence at 229 months right now. Twenty-two patients developed systemic metastases. The interval to systemic metastasis recurrence after pulmonary resection ranged from 1 to 17 months (median, 3.5 months) and 21 died of OTC at 9.5 months median (range: 1-26 months) after metastasectomy. One patient was alive with disease at 24 months after metastasectomy but was lost to follow-up. Conclusions: Most patients who had OTC pulmonary metastasectomy died of the disease within two years. Even for patients with a solitary metastasis, surgical resection for OTC pulmonary metastases is not a recommended treatment option.