The epidemiologic data on oral lesions in native Indians remain unknown in many countries around the world. This paper reports the prevalence and distribution of oral congenital anomalies and pathologic lesions found in a survey of 107 schoolchildren (ages 12 to 17), from two isolated communities in the ethnographic Mazahua area in the State of Mexico. The main entities identified were: pigmented lesions (47.6%), lingual anomalies (17.4%) and developmental tooth alterations (6.9%). The remaining 24.4% of the lesions were gingival inflammatory hyperplasia, partial ankilosis of the tongue, lichen planus, focal epithelial hyperplasia and the double lip. The most frequent localization was lips and tongue. These findings suggest the high prevalence of oral anomalies in this Indian population. Therefore, we suggest that health programs should emphasize the prevention, diagnosis and treatment of these pathologies in Indians groups.