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Oral cancer is a common malignant tumor of the head and neck region, significantly impacting human health and quality of life. Radiotherapy has become an essential component of treatment, often used in combination with surgery and/or chemotherapy. Advances in radiotherapy techniques, such as intensity-modulated radiotherapy, image-guided radiotherapy, and proton beam therapy, have markedly improved clinical outcomes. Intensity-modulated radiotherapy, for example, has demonstrated 5-year overall survival rates ranging from 60 to 75%, with better local control and reduced toxicity compared to conventional radiotherapy. Proton therapy has shown promising results in sparing normal tissues and achieving high-dose conformity, leading to improved quality of life and comparable tumor control. This review highlights the recent technological developments, explores underlying molecular mechanisms and predictive biomarkers, and discusses future directions in the radiotherapeutic management of oral cancer, aiming to provide clinically valuable insights and evidence-based recommendations.