Oral cavity squamous cell carcinoma is one of the most frequent cancers in the head and neck region. It is of epithelial origin and most commonly appears in people who smoke cigarettes and consume alcoholic drinks, especially spirit. The primary tumor can appear anywhere in the oral cavity, but three of the most common sublocalizations are tongue, floor of the mouth and retromolar area. The main metastatic path for squamous cell carcinoma of the oral cavity is lymphatic in the regional lymph nodes of the neck. Occult metastases in regional lymph nodes is the most important prognostic factor. Depending on the size and stage of the primary tumor, it is often recommended to make an elective neck dissection due to risk of regional occult metastases. The goal of this retrospective study was to determine the frequency and localization of occult regional metastasis in patients with oral squamous cell carcinoma. This retrospective study included 82 patients with histologically verified squamous cell carcinoma of the oral cavity during the 5-year period (2007-2012). According to the results of this study, the frequency of regional occult metastases was 45.12%. The most common pathological stage is T2 stage, and the incidence of regional occult metastases in T2 stage is 36.84%. With a higher T stage, the probability of regional occult metastasis increases. The most frequent localization of regional occult metastasis in oral squamous cell carcinoma was in the region I of the neck in 56,76% of patients.