The incidence of malignant tumors of the oral cavity increases annually; more than 60% of patients are diagnosed at stages III and IV when they first visit healthcare facilities, which requires combined or combination treatment. Despite the development of current treatments, the main reason for low life expectancy is a high recurrence rate. Surgical treatment for patients with recurrent squamous cell carcinoma of the oral cavity provides better overall and relapse-free survival rates than do other treatments, as evidenced by meta-analyses, but it is also frequently ineffective. The results and possibilities of salvage surgery are often limited by the previous treatment of the primary tumor, the patient’s condition, and other factors. When choosing a treatment policy, it is important to evaluate indications for surgical treatment and to determine whether the latter will lead to a better quality of life or longer survival. The prognostic preoperative and postoperative factors identified by multivariate analyses, as well as the development of prognostic scales to improve the selection of patients for salvage surgery are presented in a number of publications. This review is devoted to this relevant topic.