Objective To study the expression of hypoxia inducible factor- 1α(HIF- 1α)protein in buccal carcinoma and its biological significance. Methods The expression of HIF- 1α was assayed by means of immunohistochemical technique in 60 patients. The expression of HIF- 1α and its relationship with clinical pathological factors and tumor prognosis were investigated and analyzed statistically by Kruskal-Wallis Test. Results The positive rate of HIF- 1α was higher in T3- 4 than T1- 2, and the positive rate of HIF- 1α was higher in patients with cervical lymphatic metastasis than patients without cervical lymphatic metastasis. Patients with HIF- 1αover- expression had poor prognosis than patients with HIF- 1α lower expression. Conclusion Over- expression of HIF- 1α is a vital biological marker in prognosis of buccal cancer.