Background:Oral mucosal lesions usually present as abnormal alterations in colour, structure, surface texture, consistency, loss of integrity or as a growth in the oral mucosa. Oral potentially malignant disorders are of particular importance as they may progress into malignancy. The present study was conducted to assess the prevalence and distribution of oral mucosal lesions associated with tobacco habit in a private hospital and effect of tobacco usage on the mucosal changes. Materials & Methods:All the patients with oral mucosal lesions seen between 2019 and 2021 were studied retrospectively. Demographic data, clinical data and tobacco habits were retrieved. IBM SPSS version 20 was used to perform the statistical analysis, and the mean, frequency, and percentage were calculated. Results:Among 71807 outpatients who reported to the dental college, 28863 (40.19%) patients were diagnosed with oral mucosal lesions. Out of all the oral mucosal lesions, tobacco associated lesions were 28.81% (8314) and were most common in males. The most common tobacco related oral lesions in males were leukoplakia (37.29%) followed by oral submucous fibrosis (30.08%). The most common tobacco associated lesions in females were oral submucous fibrosis (3.01%). Conclusion:We conclude that the dental practitioner should have adequate awareness and knowledge about the diagnosis and management of oral lesions. 37.85% of oral mucosal lesions were potentially malignant disorders and use of tobacco products increased the risk for oral mucosal changes.