Oral cavity cancer is a lethal and deforming disease of rising global significance. We have previously highlighted limitations in contemporary awareness regarding sociodemographic influence on the prognosis and management of patients in Australia. Patients’ marital status has been proposed as an independent prognostic factor for various cancers but few data exist in relation to oral cancer outcomes. This study, a retrospective analysis of 21,858 Queensland oral cancer patients diagnosed over a 31-year period, confirmed a protective effect for marriage on survival, after adjustment for age and tumour characterisation. The benefits of marriage, however, were significantly greater for men than women, implying an important differential effect. Clinicians should be cognisant of the psychosocial influences on patient outcome following cancer treatment, and should consider the use of all available social support mechanisms to optimise patient survival and quality of life.