A case of bilateral elongated styloid processes in a patient with cancer of the floor of the mouth is reported.<BR>A 67-year-old man was referred to our hospital because of a tumor arising in the floor of the mouth. He had no symptoms suggesting styloid syndrome. Computed tomographic and radiographic examinations revealed bilateral elongated styloid processes. The tip of the right process extended to the lesser cornu of the hyoid bone and formed tubercle, and the tip of the left process extended to the level of the mandibular angle region. After radiotherapy for the cancer of the floor of the mouth, he underwent neck dissection, excision of the cancer, and shortening of the right styloid process. The surgical defect resulting from ablation of the cancer was reconstructed with the use of a free forearm flap. Histopathological examination of the styloid process showed that the cartilage of the tip had the potential to grow and mature to bony tissue in the future.