Metastasis to lymph nodes from oral squamous cell carcinoma (OSCC) without neck dissection classification (lingual lymph nodes (LLN) and lateral retropharyngeal lymph nodes (LRPN) ) is rare and difficult to deal with. The aim of the present study was to assess the treatment modality and prognosis of LLN and LRPN in patients diagnosed with OSCC. This retrospective study involved a chart review of the clinical records of OSCC patients diagnosed with LLN or LRPN metastasis between June 2008 and March 2021. Data were collected and treatment outcomes were analyzed. Two OSCC patients with primary LRPN metastasis underwent LRPN dissection or superselective intra-arterial chemoradiotherapy. One patient with recurrent lateral LLN underwent surgery. Seven patients with recurrent LRPN and 7 patients with recurrent para-hypoid lymph nodes underwent chemoradiotherapy, bioradiotherapy, immune checkpoint inhibitors (ICIs) or best supportive care. The cumulative 1-year overall survival rate was 25.8% on LLN (especially para-hyoid lymph node) , and 33.3% on LRPN. Cetuximab or ICIs are important to determine an effective treatment strategy for LLN or LRPN metastasis in the future.