INTRODUCTION: Head and neck cancer (HNC) is the sixth most common cancer with 500,000 cases diagnosed per year worldwide. Oral squamous cell carcinoma (OSCC) is accounting for more than 90% of total cases. Among all factors influencing the prognosis of OSCC, development of lymphatic metastasis is considered the single most important one. Morphological evaluation of the reactive patterns of regional nodes has aided in understanding the immune response to malignancy. The World Health Organization (WHO) categorized this reactive pattern into lymphocytic predominance, germinal center predominance, sinus histiocytosis, unstimulated pattern and lymphocytic depletion. Assessment of lymph nodes immuno- reactivity is an important indicator of the host response status and prognosis of OSCC. OBJECTIVES: To Assess the immuno-morphological patterns of both positive and negative lymph nodes draining OSCC and correlate these patterns with the clinical finding and the histological grading of the primary tumor. Material and Methods: Histopathological examination had been done on 30 cases of OSCC with neck dissection and immuno-morphological patterns had been detected and correlated with the grading of primary tumor. Results: A statistical analysis of the distribution of the 5 patterns of lymph nodes in 3 grades of OSCC was done using chi square test. Significance difference was revealed only in two patterns (lymphocytic depletion and normal unstimulated patterns) .other 3 patterns was found to be non-significant. CONCLUSIONS: lymphocytic depletion and unstimulated mixed patterns of draining lymph nodes was significantly correlated with the grade of the tumor and it could be used as an indicator for prognosis and early metastasis of OSCC. However, no correlation was found between the other patterns and the histological grading.