Background: We evaluated usefulness of Mallampati test, Inter incisor distance, Thyromental distance and Sternomental distance in predicting difficult intubation in oral cancer surgery patients. Methods: Preoperatively, assessment of airway predictors was done in 111 patients undergoing oral cancer surgery. Difficult intubation was defined as Cormark and Lehane grading of grade 3 & 4. Results: Incidence of difficult intubation was found to be 18% patients. By using Receiver operating characteristic analysis, Inter incisor distance < 2.55 cm, Thyromental distance < 8.75 cm were found to be the cut off points of difficult intubation. Sensitivity and specificity for predicting difficult intubation by Interincisor distance was 60% and 78% respectively with a positive predictive value of 39% and with higher negative predictive value of 89%. AUC (area under curve) with 95% confident interval showed 0.69% for Inter incisor distance, 0.64% for Thyromental distance and 0.57% with Sternomental distance. Conclusions: Inter incisor distance and Mallampati grading was a better predictor compared to other parameters and Sternomental distance showed the least significance in predicting a difficult airway in oral cancer surgery patients.