Tongue cancer is one of the most aggressive oral cavity malignancies. It is more common in Southeast Asia. Epidemiology in Africa and Arab countries is not well studied. Herein the authors searched the hospital-based registry for tongue cancer patients whether surgically treated or not. The authors retrieved 156 cases eligible for the study. The tumour mainly affected older individuals with a male to female ratio of 1.04:1. Most of the patients received surgical treatment mainly partial or hemiglossectomy with either elective or therapeutic neck dissection. Overall survival was affected by age and recurrence, while disease-free survival was affected by age, grade, T stage, lymph node status, type of surgery and adjuvant therapy. In conclusion, population based registries are needed to further quantify the risk of disease in Africa and the Middle East. In addition, high treatment failure after classic treatment of tongue cancer warrants further research in identifying underlying aetiology and implementing neoadjuvant and adjuvant therapy in the treatment tools.