Oral squamous cell carcinoma (OSCC) remains a major cause of cancer-related mortality worldwide, with limited biomarker-driven tools for risk stratification. CD147 is a membrane glycoprotein implicated in tumor metabolism, invasion, immune evasion, and therapy resistance. This study aimed to evaluate the prognostic and predictive relevance of CD147 expression in distinct tumor compartments of OSCC. Formalin-fixed tumor samples from 229 OSCC patients were analyzed via tissue microarray and immunohistochemistry to assess CD147 expression in the tumor center, periphery, and adjacent mucosa. Associations with clinicopathological parameters, survival, and therapy response were evaluated using non-parametric statistical tests, Kaplan–Meier, multivariate Cox, and binary logistic regression analyses. Complementary transcriptomic and immunological analyses were performed using The Cancer Genome Atlas (TCGA), the University of Alabama at Birmingham Cancer data analysis (UALCAN), Tumor and Immune System Interaction Database (TISIDB), and the Genotype-Tissue Expression (GTEx) project’s datasets. Low CD147 expression in the tumor invasive front was independently associated with improved overall survival, while expression in the tumor center or mucosa showed no prognostic value. No significant associations between CD147 and adjuvant therapy response were identified. TCGA-based analyses confirmed CD147 overexpression in tumors and its correlation with immunosuppressive signaling and resistance-associated transcriptional networks. Peripheral CD147 expression serves as a compartment-specific, independent prognostic marker in OSCC in this retrospective single-center cohort. Its spatially restricted prognostic relevance and association with immune modulation and therapy resistance highlight CD147 as a promising candidate for future biomarker-driven and therapeutic strategies.