UNLABELLED: Locally advanced oral carcinoma requires extensive surgical intervention, leading to significant postoperative nutritional challenges. Percutaneous Endoscopic Gastrostomy (PEG) feeding has emerged as a preferred method over nasogastric (NG) feeding, providing consistent nutritional support that aids recovery by reducing complications and enhancing quality of life. This prospective cohort study followed 50 patients with locally advanced oral carcinoma requiring postoperative PEG feeding. Patients were assessed over a 6-month period for nutritional status (BMI, serum albumin), inflammatory markers (CRP, ESR), quality of life (EORTC QLQ-C30), and psychosocial well-being (HADS). Complication rates and patient satisfaction were also recorded. After 6 months, mean BMI increased from 18.5 ± 2.5 kg/m² to 19.0 ± 2.7 kg/m², while serum albumin rose from 2.8 ± 0.5 g/dL to 3.4 ± 0.5 g/dL, indicating nutritional recovery. CRP and ESR levels declined from 25 ± 5 mg/L to 15 ± 3 mg/L and 30 ± 7 mm/hr to 22 ± 5 mm/hr, respectively, reflecting reduced inflammation. Quality of life scores improved, with global health rising from 50 ± 10 to 70 ± 15, and anxiety and depression scores decreasing from 12 ± 4 and 14 ± 4 to 8 ± 3 and 9 ± 3. The complication rate was low (30%), and patient satisfaction increased from 7.5 ± 1.2 to 8.5 ± 1.1. PEG feeding significantly improves nutritional recovery, reduces inflammation, and enhances quality of life in postoperative oral carcinoma patients, supporting its role as a standard of care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12070-024-05313-3.