Abstract: Objective: To evaluate the clinical pathological factors affecting contralateral neck lymph node metastasis in oral squamous cell carcinoma (OSCC), and provide clinical evidence of prophylactic contralateral neck dissection for surgeons. Methods: A total of 238 OSCC cases were retrospectively reviewed from Jun. 2010 to Dec. 2012 in the Department of Oral and Maxillofacial Surgery, Xiangya Hospital of Central South University. The impact of multiple clinicopathologic factors, including age, sex, course of disease, primary site, T-stage, type of neck dissection, ipsilateral metastatic lymph nodes and histopathological grading were assessed by logistic regression analysis. Results: Univariate logistic regression analysis showed that contralateral neck lymph node metastasis was significantly increased in the OSCC patients with T3/T4 stages, moderately and poorly cell differentiation, or ipsilateral neck lymph node metastasis. Multivariable logistic regression analysis showed that only pathology grade was high risk factor for contralateral neck lymph node metastasis of OSCC. Conclusion: Prophylactic contralateral neck dissection should be considered if patients in the middle stage of the tumor had more than two signs as followed: T3/T4 tumor stage, ipsilateral clinically lymph node-positive, and poorly differentiated.