New York State (NYS) ranks 3^rd among all states in the US for the number of new cases and number of deaths due to oral and pharyngeal cancer. According to the SEER report, Hispanics have one of the lowest incidence rates of oral and pharyngeal cancers in the U.S. In 2000, Hispanics accounted for 15.1% of the population in NYS and 27% of the population in New York City (NYC). As part of a statewide needs assessment of the oral cancer burden in NYS, we examined the age adjusted incidence and mortality rates of oral and pharyngeal cancers by race, ethnicity, region of residence (Upstate versus NYC) and NYC neighborhoods to develop appropriate oral cancer control interventions. Data from the NYS Cancer Registry was compared to data from SEER cancer statistics for the years 1996 to 2000. The age-adjusted incidence rates for Hispanic males and females in NYS were approximately 2.4 and 1.6 times higher, respectively, than the rates reported by SEER. Moreover, the incidence rates for Hispanic males and females were approximately 2.7 and 1.6 times higher in New York City. New York State Hispanics have a much higher burden of oral and pharyngeal cancer than the nation as a whole. Interventions are needed to deliver oral cancer prevention and early detection messages to this population in a culturally appropriate manner. In addition, more research is needed to assess potential differences in rates and risk factors among subgroups of Hispanics.