Oral Pyogenic Granuloma (PG) is inflammatory hyperplasia, that mostly affects the gingiva. It usually affects young adults and is seldom seen in the elderly population. While in most cases, PG rarely attains a size larger than 3 cm, in certain cases rapidly growing extensive lesions may be confused with malignancy. In the present article, the authors report two cases of an unusually large oral pyogenic granuloma clinically mimicking oral carcinoma. A review of the literature was also performed to identify similar cases and also those in which a malignant lesion resembled PG. The present article emphasizes the importance of a timely biopsy of all the oral pathological lesions and a thorough histopathological study preceding and deciding the final treatment plan