We undertook this study to evaluate the possible etiological factors responsible, the epidemiological pattern, role of adjuvant vitamins and anti-oxidants in oral leukoplakia. MATERIALS AND METHODS: A prospective study of a hundred patients attending the outpatient department ofboth the institutions presenting with oral white lesions. Those cases in which a specific cause (infective, systemic disease or specific disease entity) for the white lesions were elicited were excluded from the study of two institutions. A written informed consent was taken from all the patients participating in the study. Local ethical body committee approval was taken. RESULTS: In this study there was 63%homogenous, 18% ulcerative, 16% nodular and 3% verrucous type of lesions. Out of them 67% showed epithelial hyperplasia, 19% showed mild dysplasia, 10% were severely dysplasticand 15.5% of nodular/verrucous, 16.5% of ulcerative leukoplakia were confirmed histologically to be malignant.Clinical improvement was seen in 90% of cases who had reduced risk factors with antioxidant supplementations than 48.8% of those who don’t. CONCLUSION: Persistent leukoplakia has a potential for malignant transformation, toluidine blue is rapid, practical, inexpensive adjunct diagnostic tool. Anti-oxidant supplementshave beneficial effect in subjects with reduced risk factors.