The most common form of metastasis for gingival squamous cell carcinoma is local lymph node metastasis, and a small percentage will metastasize to distant sites such as the lungs, kidneys, and liver with blood flow. Lymph node metastasis of gingival squamous cell carcinoma is a biological characteristic of oral cancer. Local lymph nodes mainly refer to the lymph nodes in the neck as well as under the jaw, and lymph node metastasis of mandibular gum cancer appears earlier than that of maxillary gum cancer and is more common at the same time. Mandibular gum cancer mostly metastasizes to submandibular and subchin lymph nodes, and finally to deep cervical lymph nodes, while maxillary gum cancer most commonly metastasizes to submandibular lymph nodes and then to deep cervical lymph nodes. Lymph nodes in oral, maxillofacial and cervical areas are divided into Zone I, Zone II, Zone III and Zone IV. In the past, it was thought that mandibular gingival cancer was prone to lymph node metastasis, so lymph node dissection should be performed, while maxillary gingival cancer, with a lower rate of lymph node metastasis, could be treated without lymph node dissection. However, the latest research results now show that lymph node dissection must be performed for gingival cancer in the maxillary posterior region, because clinical studies with large samples have found that gingival cancer in the maxillary posterior region is most likely to have lymph node metastasis in region II.