In day-to-day practice, we give diagnosis of oral soft tissue lesions like oral lichen planus, pemphigus vulgaris, mucous membrane pemphigoid (MMP), leukoplakia, erythroplakia by history, clinical examination, and histological findings. But imaging modalities are never used for the diagnostic purpose of the above-mentioned lesions, though conventional ultrasonography (US) has been routinely used for the evaluation of various pathologies of maxillofacial region with frequency ranging from 3-15 MHz. Ultra-high frequency ultrasound (UHFUS) is an emerging ultrasonographic technique which uses higher frequency ranging from 30-100 MHz (mainly 70 MHz), this limits the depth of penetration upto 10mm from surface and increases the resolution of images upto 30 μm. UHFUS usesintraoral ultrasonographic machine with 70 MHz probe for scanning two acquisitions i.e., B-mode and C-mode. Biomarkers used for diagnosis are growth pattern, epithelial thickness, echogenicity and vascularization. Thus, clinicians can give confirmatory diagnosis of oral mucosal lesions prior to histology. This article provides overview of imaging principles, underlying technology and in particular focuses on the emerging role of UHFUS in Oral medicine and diagnosis.