Primary malignancies of the hard palate are rare. Only 66 cases have been seen at the University of Virginia Hospital in the 43 years from 1932 through March 1975. These have been reviewed with regard to age, sex, race, histology and clinical presentation. There was 32 squamous cell carcinomas, 25 salivary gland tumors and 9 nonepithelial malignancies. The nonepithelial malignancies were a diverse group and are not considered further. The results of treatment for the squamous cell carcinoma group and salivary gland tumors have been analyzed by stage and mode of therapy. Although no great improvement in the results of surgery or combined therapy have been observed over the years in the squamous cell carcinoma group, there has been a dramatic improvement in the results of treatment with radiation therapy from the orthovoltage era to the super-voltage era. Primary control with radiation therapy for the squamous cell carcinoma group was 2/5 (40%) in the orthovoltage era and 7/7 (100%) in the supervoltage era. Surgery would appear to be the appropriate treatment for salivary gland tumors with possibly a place for combined therapy. Radiation therapy proved useful in salvaging certain surgical failures. The time of appearance of local recurrence following initial therapy, the incidence of distant metastases and second primary tumors were analyzed and are presented.