Objective To investigate the associations of multiple immunoinflammatory markers in peripheral blood before and after operation, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI), with postoperative recurrence and metastasis in oral squamous cell carcinoma (OSCC) patients, to provide a reference for predicting the prognosis of OSCC patients. Methods This study was approved by the hospital ethics committee, and informed consent was obtained from the patients. A total of 160 patients with primary OSCC who underwent radical surgery were grouped according to preoperative lymph node metastasis, degree of differentiation, clinical T stage, and postoperative recurrence and metastasis. The last preoperative and 1-month postoperative routine blood test results of all the patients were collected to analyze the relationship between peripheral blood inflammatory indicators, including the NLR, PLR, LMR, SII, and SIRI, before and after surgery.The above clinicopathological indicators and postoperative recurrence and metastasis were evaluated in OSCC patients. Results Among the 160 patients, there was a significant difference in the preoperative SII between the preoperative lymph node metastasis group and the no metastasis group (P<0.05); the preoperative NLR, LMR, SII and SIRI were significantly different among the different differentiation degree groups (P<0.05); and the preoperative SIRI in the different clinical T stage groups were significantly different (P<0.05). The preoperative NLR, SII and SIRI were significantly different between the postoperative recurrence and metastasis group and the no recurrence and metastasis group (P<0.05). Postoperative peripheral blood inflammatory markers were not associated with postoperative metastasis and recurrence. Univariate Cox analysis revealed that among the preoperative peripheral blood inflammatory indicators, the preoperative NLR, PLR, SII and SIRI were the factors influencing recurrence and metastasis in OSCC patients. Multivariate Cox analysis revealed that the preoperative NLR was the only independent risk factor for recurrence and metastasis in OSCC patients among the preoperative peripheral blood inflammatory indicators. Conclusion Among the peripheral blood inflammatory indicators, the preoperative NLR is an independent risk factor for postoperative recurrence and metastasis in OSCC patients and has certain predictive value.