Aim: To evaluate the impact of sarcopenia on 30-day postoperative morbidity in oral cavity squamous cell carcinoma (OCSCC), define gender-specific population cut-offs in Indian patients, and compare the discriminatory ability of various sarcopenia tools. Methodology: This prospective observational study included OCSCC patients undergoing primary curative surgery between January 2025 and January 2026. Sarcopenia was assessed using imaging-based parameters (cross-sectional area [CSA] at C3, skeletal muscle index [SMI]), functional measures (handgrip strength, gait speed, chair stand test), and biochemical indices (NLR, SII, H-index). Receiver operating characteristic (ROC) analysis determined optimal cut-offs, and discriminatory performance was compared using AUC and DeLong test. The primary endpoint was 30-day postoperative complications. Results: A total of 204 patients formed the study population, with a complication rate of 34.9%. CSA (AUC=0.621), handgrip strength (AUC=0.621), and SMI (AUC=0.617) demonstrated fair discriminatory power for complications, whereas the remaining indices failed to achieve significance. In males, combined CSA ≤34 cm² and handgrip <26 kg (which can be defined as true sarcopenic patients) significantly increased complication risk (OR 5.04, p=0.002); corresponding female cut-offs were CSA ≤22.4 cm² and handgrip <18 kg. SMI cut-offs were ≤12.5 cm²/m² (males) and ≤9.9 cm²/m² (females). Conclusion: Sarcopenia is associated with increased postoperative morbidity in OCSCC. Imaging-based objective assessment tools incorporating muscle mass (CSA at C3 and SMI) and muscle function (hand grip) are reliable and superior sarcopenia tools with fair discriminatory ability compared to biochemical indices. Incorporating these can help in preoperative risk stratification and patient optimization.