Aim: This study aims to evaluate the demographics, to analyze the clinical and pathological findings, treatment and the outcome of oral cavity squamous cell carcinomas (OSCC) in patients aged 40-years old and below in our centre. Methods: Records of patients who were diagnosed with OSCC in the Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, from 1998 to 2003 were analyzed. Their socioeconomic data such as their age, gender and race, risk factors, family history and genetic predisposition were assessed. Other data examined included the sites and stage of the tumor, histopathology results, treatment modality and outcome of OSCC. Results: There were 19 patients with no gender predilection. Malays made up most patients diagnosed with OSCC, followed by Chinese and Indians. There was no significant high-risk habit in this group. Most of the sites involved were the tongue (73.7%), buccal mucosa (15.8%) and alveolus (10.5%). Most of the patients (57.9%) were diagnosed with stage IV disease. Eighteen patients underwent treatment consisting of surgery or radiotherapy or in combination. A 5-year follow up revealed that nine patients (47.3%) survived and remain well, four patients (21.1%) had a recurrence, two patients (10.5%) died of the disease. Conclusion: The majority of patients presented with stage IV disease without any significant high-risk habit. Surgery remains the mainstay of treatment, however, 5-year follow-up showed a less than 50% survival rate.