vascular endothelial growth factor (vegf) is one of the most potent endothelial cell mitogens and plays a critical role in angiogenesis. polymorphisms in this gene have been evaluated in patients with several types of cancer. the objectives of this study were to determine if there was an association of the -1154g/a polymorphism of the vegf gene with head and neck cancer and the interaction of this polymorphism with lifestyle and demographic factors. additionally, the distribution of the vegf genotype was investigated with respect to the clinicopathological features of head and neck cancer patients. the study included 100 patients with histopathological diagnosis of head and neck squamous cell carcinoma. patients with treated tumors were excluded. a total of 176 individuals 40 years or older were included in the control group and individuals with a family history of neoplasias were excluded. analysis was performed after extraction of genomic dna using the real-time pcr technique. no statistically significant differences between allelic and genotype frequencies of -1154g/a vegf polymorphism were identified between healthy individuals and patients. the real-time pcr analyses showed a g allele frequency of 0.72 and 0.74 for patients and the control group, respectively. the a allele showed a frequency of 0.28 for head and neck cancer patients and 0.26 for the control group. however, analysis of the clinicopathological features showed a decreased frequency of the a allele polymorphism in patients with advanced (t3 and t4) tumors (or = 0.36; 95%ci = 0.14-0.93; p = 0.0345). the -1154a allele of the vegf gene may decrease the risk of tumor growth and be a possible biomarker for head and neck cancer. this polymorphism is associated with increased vegf production and may have a prognostic importance.