Background: The treatment selection for the oral squamous cell carcinoma remains controversial. Radiationtherapy or surgical excision of the lesion can be applied as the sole treatment or it can be used in combinationwith other treatment modalities. Radiotherapy is considered to be the safest of all the treatment modalities andcan be used in several situations for oral and oropharyngeal cancers. The aim of this study was to evaluate thesurvival outcome differences in patients treated with radical and palliative radiotherapy as the primary treatmentmodality. Materials and Methods: The study included a total of 47 patients with oral cancer reporting to ourhospital between years 2009 to 2010. The age group for the selected patients was more than 65 years, treatedwith radical and palliative radiotherapy with no prior surgical interventions. Patients were evaluated till Dec2013 for overall survival time. Results: Twenty nine patients were treated with radical radiotherapy as mainstay of treatment, out of which 21 died during the follow up time with median survival of 352 ± 281.7 days with8 patients alive. All the 16 patients were dead who received palliative radiotherapy with a median survival timeof 112 ± 144.0 days. Conclusions: This retrospective study showed improved overall survival time, loco regionalcontrol rates and reduced morbidity in patients treated with radical radiotherapy when compared to patientstreated with palliative radiotherapy.