Background: The incidence of oral tongue cancer (OTC) in the United States is increasing in women. To better understand this phenomenon, we examined thetime trends and racial disparities in incidence and survival in this population. Methods: We identified 6,199 women diagnosed with OTC that were reported to the Surveillance, Epidemiology and End Results (SEER) Program from 1973 to 2010. Cases were categorized by age, race, and year of diagnosis. The incidence and survival rates were compared across metropolitan, urban and rural residential settings and several other demographic categories by calculating rate ratios (RRs) with the corresponding 95% confidence intervals (CIs). We examined temporal variations in incidence of OTC across racial groups using joinpoint analyses to evaluate changes since 1973. Results: Cases were predominantly white (85.5%), and 60-64 years of age. OTC incidence in white females demonstrated a statistically significant increase with 0.53 annual percentage change (APC) between 1973 and 2010. For African American (AA) females, on the other hand, the incidence has decreased by -2.79 APC since 1973. Overall incidence was higher among white women (1.30 cases per 100,000/year) compared to AA women (0.67 cases per 100,000/year). Comparisons across residential settings produced similar results wherein incidence rates among women living in metropolitan areas were significantly lower for AA females compared to white females (RR=0.51; 95% CI: 0.43-0.60). The 1-, 5- and 10-year relative survival estimates (RS: defined as observed survival among cancer patients divided by the expected survival in the general population) for all women with OTC were 85%, 63% and 53%, respectively. When stratified on race, the corresponding 1-, 5- and 10-year race specific RS estimates were 86%, 63% and 54% for white women, and 76%, 46% and 33% for AA women. Conclusions: The racial disparity in survival of women with oral tongue cancer is pronounced. Identifying the demographic characteristics of white women with OTC may lead to a better understanding of the causes behind the increased incidence in this group.