[Abstract] Mortality from oral cancer has been rising appreciably in most European countries up to the late 1980s, essentially for men. To update trends in oral cancer, death certification data from oral and pharyngeal cancer for 27 European countries were abstracted and analysed from the WHO mortality database over the period 1980-99. Oral cancer mortality in men has started to decline since the late 1980s in most western countries, although some persisting upward trends were registered for Belgium, Denmark, Greece, Portugal, or Scotland. Persisting rises were observed for most central and eastern Europe up to the mid 1990s, reaching exceedingly high rates in Hungary (20.2/100000 at all ages, 51.4 at age 35-64), Slovakia, Slovenia, and the Russian Federation. Some levelling of rates in some countries, such as Poland or the Czech Republic, was observed over more recent calendar years. Oral cancer was low, but moderately upwards in European women, mainly from central and eastern Europe. These trends should be essentially interpreted in terms of patterns and changes in exposure to alcohol and tobacco, and call for urgent control of these factors, as well as for improved diagnosis and management of oral cancer in central and eastern Europe. [Authors]