Abstract: Oral cavity cancer is the most common type of head and neck squamous cell carcinoma, and patients with locally advanced cancer are mainly treated via surgical resection, followed by adjuvant radiotherapy. However, over the past decade, therapeutic progress in locally advanced oral cavity cancer has been limited, with the overall survival remaining below 50%. Although many studies have reported high tumor response rates with neoadjuvant chemotherapy and targeted therapy, these findings have not translated into enhanced patient survival. Neoadjuvant immunotherapy has become a research hotspot owing to the success of immunotherapy with immune checkpoint inhibitors for relapsed and metastatic head and neck squamous cell carcinoma cases, with many ongoing randomized controlled studies focusing on drug discovery. In this review, we discuss the relevant clinical studies and highlight the therapeutic advancements in neoadjuvant immunotherapy for locally advanced oral cavity cancer.