BACKGROUND Oral health is important to individuals of all age groups. Previous epidemiologic studies of the oral health status of the general population in India provided very little information about oral mucosal lesions in the elderly. Hence, the purpose of the present study was to determine the prevalence of the oral lesions in a geriatric Indian population. METHODS 5,100 patients were clinically evaluated, with age ranging from 60 to 98 years. There were 3,100 males and 2,000 females, with a mean age of 69 ± 6.3 yrs. The statistical analysis was done using the SPSS software, where p < .05 was considered to be significant. RESULTS 64% of the patients presented with one or more oral lesions, associated to tobacco, betel nut consumption, and lesions secondary to trauma and prosthesis. Males were more affected than females and this difference was clinically not significant (p > .05). The lesions were more frequently observed between 65 to 70 yrs. The most common alterations observed were smoker's palate (43%), denture stomatitis (34%), oral submucous fibrosis (30%), frictional keratosis (23%), leukoplakia (22%), and pyogenic granuloma (22%). Hard palate was the most commonly affected site (23.1%). CONCLUSIONS The findings of the present study provide important information when clinically evaluating oral cavity in elderly. Close follow-up and systematic evaluation is required in the elderly population to plan future treatment needs.