Background: Laser ablation of soft tissue tumors is fast gaining ground in the field of Oncology. Conventional Oral cancer treatment is blamed most often for a radical dip in Quality of Life post-surgery and Radiotherapy. Mutilation, Mouth closure, inability to speak, eat or drink normally discourages patients to adopt surgery in early stages or even treatment as a whole. Laser technology uses controlled heat to burn the cancer affected tissues under sonography control. The new technique of Laser Ablation has removed the need for cutting of face and the need for radiotherapy. Methods: 54 patients were diagnosed with stage 4 inoperable cancer on clinical and radiological examination. Criteria for inoperability were size of tumor more than 3.5 cms and less than 5 cms, involvement of upper or lower Gingivo buccal sulcus with or without involvement of bone. Laser ablation was achieved by using 980mm diode laser. The margins of effective tumor ablation are assessed under sonography. The lymph nodes were laserised percutaneously under sonography control. Post operatively patients were administered chemotherapy by a standard cisplatin, paclitaxel and 5Fu 3 weekly for 6 cycles. Results: All patients showed a decrease in their swelling within 1 month of the procedure. There was an increase in appetite and well being within 2 weeks of the procedure. 47 (90%) patients had a total resolution of the tumor with laser and chemotherapy at 2 months. MRI scans done after 3 months showed a resolution of the original lesion with resolution of lymph nodes. 8 patients (9%) showed a recurrence in the operated area which did not settle on repeat laserisation. These patients underwent standard commando operation at other institutions. 41(75%) patients showed an MRI consistent with no active cancer at 8 months. All of these patients had a weight increase from 4 to 10 kgs compared from pre laser weight over this period. 13 (24%) patients showed a recurrence in neck lymph nodes after 8 months. Of these patients 8 (60%) patients showed a good response to laserisation of the affected node. Over all 80% of patients of stage 4 inoperable buccal cancer were in remission at 2 years with no sign of cancer on MRI scans. Conclusions: Laser ablation of oral cancer in late stage oral cancer should be offered as an alternative to patients not willing for a standard commando operation. Skill sets required for the same are different from conventional surgery. It involves a working knowledge of sonography and has a short learning curve.