Oral cancer squamous cell carcinoma (OCSCC) mainly affects individuals aged between 50 and 70 years who consume tobacco and alcohol. tobacco smoke contains hundreds of known toxic and carcinogenic molecules, and a few studies have sought to verify the relationship of such trace elements as risk or prognostic factors for head and neck cancer. We obtained 78 samples of tumor tissues from patients with ocScc, and performed a qualitative elemental characterization using the micro X-Ray fluorescence technique based on synchrotron radiation. We found the presence of magnesium, phosphorus, sulfur, chlorine, potassium, calcium, chromium, manganese, iron, zinc, cobalt, nickel, copper, arsenic and bromine in ocScc samples. Magnesium, chlorine, chromium, manganese, nickel, arsenic and bromine are associated with smoking. We observed a significant association between relapse and chlorine and chromium. the presence of chlorine in the samples was an independent protective factor against relapse (oR = 0.105, CI = 0.01-0.63) and for best disease-free survival (HR = 0.194, CI = 0.04-0.87). Reporting for the first time in oral cancer, these results suggest a key relationship between smoking and the presence of certain elements. in addition, chlorine proved to be important in the context of patient prognosis and survival. Squamous cell carcinoma (SCC) accounts for more than 90% of oral cancer cases 1,2 and mainly affects individuals aged between 50 and 70 years who consume tobacco and alcohol. It may also be associated with human papillomavirus infection, genetic susceptibility and passive smoking exposure 1-5. Tobacco smoke itself, which contains hundreds of known toxic and carcinogenic molecules 6,7 , can induce DNA damage 8. Among these substances are several inorganic compounds, such as arsenic, calcium, chlorine, cobalt, copper, chromium, iron, magnesium, manganese, nickel, potassium, zinc and others 9,10. The analysis of trace elements is quite uncommon in the head and neck cancer field. Over the past two decades, a few studies have sought to verify the identity of these and other trace elements as risk or prognostic factors for head and neck cancer. Some authors verified the differences in the profile of trace elements in the blood (plasma/serum) of patients with or without head and neck cancer 11-19. Differences were also found in the analyses performed on the hair and nails of patients with head and neck cancer 15,17,20,21. However, in studies carried out