Abstract Background To investigate whether quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters can be used to predict the pathologic stages of oral tongue squamous cell carcinoma (OTSCC). Methods For this prospective study, DCE-MRI was performed in participants with OTSCC from May 2016 to June 2017. The pharmacokinetic parameters, including K^trans, K_ep, V_e, and V_p, were derived from DCE-MRI by utilizing a two-compartment extended Tofts model and a three-dimensional volume of interest. The postoperative pathologic stage was determined in each patient based on the 8th AJCC cancer staging manual. The quantitative DCE-MRI parameters were compared between stage I–II and stage III–IV lesions. Logistic regression analysis was used to determine independent predictors of tumor stages, followed by receiver operating characteristic (ROC) analysis to evaluate the predictive performance. Results The mean K^trans, K_ep and V_p values were significantly lower in stage III–IV lesions compared with stage I–II lesions (p = 0.013, 0.005 and 0.011, respectively). K_ep was an independent predictor for the advanced stages as determined by univariate and multivariate logistic analysis. ROC analysis showed that K_ep had the highest predictive capability, with a sensitivity of 64.3%, a specificity of 82.6%, a positive predictive value of 81.8%, a negative predictive value of 65.5%, and an accuracy of 72.5%. Conclusion The quantitative DCE-MRI parameter K_ep can be used as a biomarker for predicting pathologic stages of OTSCC.