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Background The aim of the study was the immunohistological assessment of VEGF-single nucleotide polymorphism ( SNP)-related angiogenic activity in oral squamous cell carcinoma ( OSCC) in correlation with prognosis. Methods Fifty OSCC samples were immunostained with CD31-antibodies. Mean microvessel density ( MVD) and staining intensity were determined and associated with clinicopathological/prognostic features as well as with the VEGF +936 C/ T SNP. Results A significant higher MVD could be seen for T3 and T4 compared with T1 and T2, N > 0 vs. N0 as well as G3-G4 vs. G1-G2 OSCCs (all: P < 0.05). A higher MVD was also associated with increased and earlier rates of local relapses, more metastases, and a significant decreased overall as well as disease-free survival (all: P < 0.05). When comparing T1 and T2 samples with +936-T-allele with T 1&2 samples without this allele, staining intensity was significantly increased ( P = 0.002). Conclusions Angiogenesis influences local as well as distant growth of OSCCs with a significant correlation between prognostic parameters. The correlation between VEGF +936- T-allele and increased CD31 immunostain needs further confirmation. [ABSTRACT FROM AUTHOR]