<p>Oral squamous cell carcinoma (OSCC) is the eighth most prevalent cancer worldwide (Bray et al. in CA Cancer J Clin 68:394, 2018) with India carrying one-third of the global burden (Laprise et al. in Int J Cancer 139:1512–1519, 2016). About 60–80% of these patients are detected in the advanced stages with malignancies involving the tongue invariably having an associated component of floor of mouth (FOM) either by primary involvement or forming the base of resection. Such lesions are associated with several morbidities such as speech, swallowing and breathing difficulty. Hence, a balance of adequate oncological margins and optimal functional outcome is a challenge in these malignancies. The pull-through technique was devised for combined en-bloc resection of tongue cancers and cervical lymphatics. We aim to assess the functional outcome of this technique in locally advanced Tongue and FOM cancers. A retrospective observational study was done for patients operated from Jan 2021 to Jan 2023. A total of 102 patients undergoing resection by pull through approach were included. Six months after the treatment, Speech, swallowing and breathing were assessed using HNC FIT (Functional Integrity) scales. A total of 102 patients were included in the study with 74(72.6%) males and 28(27.4%) females with a median age of 47 years (30–76 years). Median duration of tracheostomy removal was 7th postoperative day and 77(75.4%) patients were decannulated by the time adjuvant therapy was completed. 79(77.4%) patients tolerated solid/semi-solid food while 76(74.5%) patients were able to communicate with comprehensible speech. Pull through approach is an effective modality with acceptable functional outcome in cases of Locally advanced tongue lesions.</p>