Objective To investigate the expression of survivin during oral carcinogenesis and its relationship with the expression of Bcl-2 and p53.Methods Two-step immunohistochemical method was employed to detect the expression of survivin, Bcl-2 and p53 in 60 rat tongue carcinogenesis specimens induced by 4-nitro-quinoline 1-oxide (4NQO).Results Survivin was present in 1/36 cases of normal mucosa,6/11 cases of oral epithelial dysplasia and 10/11 cases of oral carcinoma.There were significant difference in the expression of survivin among normal mucosa, oral epithelial dysplasia and carcinoma (P < 0.001) .While in the 17 cases of positive expression of survivin, Bcl-2 was present in 12 cases and p53 was present in 8 cases.The expression of survivin in oral epithelial dysplasia and carcinoma were significantly higher than that in normal oral mucosa(P < 0.01).The expression of survivin was positively correlated to the expression of Bcl-2 and p53 in rat tongue(P < 0.01).Conclusions The expression of survivin may play an important role in oral carcinogenesis.Survivin, Bcl-2 and p53 may be synergetic in the carcinogenesis of oral cancer.