The last decade has seen the development of compartmental surgery (CTS) as a whole new approach to the treatment of advanced head and neck cancer. CTS is based on a new concept and a new approach to demolition and reconstruction that focus on: the removal of the whole anatomo-functional units containing the tumor, including all the potential pathways of progression such as muscular, lymphatic and vascular; identification of territories at high risk of recurrence of disease such as muscular, neuro-vascular and glandular tissues; accurate consideration of the defect resulted from the anatomical demolition and the subsequent rational reconstruction. The aim of this paper is to retrospectively evaluate our series, to describe our experience with CTS and the oncological and functional results in patients with squamocellular oral cavity cancers of the tongue and the floor of mouth.In this study we evaluated oncological and functional follow ups of patients treated from 2007 to 2012, by a retrospective analysis of the data stored in our oncological digital database (Spider’s net). We evaluated 114 patients with cT2–4a, cN0, cN+, M0 squamocellular cancers of the tongue and the floor of mouth. Reconstructions were performed by a variety of flaps including ALT (52), DIEP (15), VRAM (7) Fibula free flap (19), radial forearm free flap (14) and myofascial pectoralis flap (7).We discuss our experience of this surgical technique with focus on the functional results of reconstructions performed in our patients. Oncological outcomes and long term follow ups are also discussed.In our opinion, CTS is the gold standard primary treatment for cancers of the tongue and of the floor of mouth.