Abstract Background: One of the most common habits is tobacco use, which is linked to the emergence of potentially cancerous conditions. A significant public health issue, mouth cancer is increasingly affecting both young men and women. Usually, aberrant changes in the oral mucosa's colour, texture, or integrity are the first signs of oral mucosal lesions. Because they have the potential to develop into cancer, oral potentially malignant illnesses are very significant. Aim: The aim of the present study was to investigate the prevalence and distribution of oral mucosal lesions (OMLs) among smoke and smokeless tobacco users and the relative risk of developing oral lesions associated with these habits. Materials And Methods: A retrospective study of all cases of oral mucosal lesions observed from 2019 to 2021. Data on tobacco use, clinical information, and demographics were obtained from Fathima dental hospital at Vellore. Various examination techniques of the mouth and topography of the oral mucosa and brush biopsy technique was carried out for data collection with around 80 oral cancer patients visiting the clinic Statistical analysis was performed using SPSS version 20, and the mean, frequency, and percentage were calculated. Results: Among 80 outpatients who reported to the dental hospital, 61(76.2%) patients were diagnosed with oral mucosal lesions. Out of all the oral mucosal lesions, tobacco associated lesions were 23 (28.75%) and were most common in males. The most common tobacco related oral lesions in males were leukoplakia 31 (38.75.%) followed by oral submucous fibrosis 44 (55%). The most common tobacco associated oral lichen planus were 05 (6.25%). Conclusion: The study comes to the conclusion that a dentist should be sufficiently informed of and knowledgeable about the diagnosis and treatment of oral lesions. Along with the assessment process, it is advised in daily practice and absolutely for examiners undertaking a study to record lesions in a standardised manner based on clearly defined topographical land markings. Keywords: Leukoplakia, Lichen Planus, Oral Potentially Malignant Disorders, Oral Submucous Fibrosis, Precancerous lesion, Tobacco use, oral cancer.