The relation between diet and risk of oral and pharyngeal cancer was analysed in a case-control study conducted in North-East Italy between 1996 and 1999. Cases were 132 patients (including 33 women), with incident, histologically confirmed cancer of the oral cavity or pharynx, and controls were 148 subjects (including 45 women) admitted to hospitals for acute conditions unrelated to smoking or alcohol drinking. After allowance for tobacco, alcohol and several other potential confounding factors, significant inverse association with the risk of oral and pharyngeal cancer was found for consumption of total green vegetables (OR 0.37) and total fruit (OR 0.34) with significant trends in risk. Compared with alcohol drinkers of < 20 drinks/week and eating > 13 portions/week of total green vegetables, the OR for drinkers of ≥ 20 drinks/week and eating < 7 portions/week of green vegetables was 15.44. Our study provides further support to the beneficial effect of high intake of vegetables and fruit, particularly in heavy smokers and alcohol drinkers.