The prevalence of oral leukoplakia and related lesions in a Kenyan rural population was determined in a systematic house to house survey of individuals aged 15 years and above. Among the 803 individuals examined, the following prevalence of lesions was observed: leukoedema (26%), melanosis (12.7%), leukoplakia (10.6%), palatal keratosis (6.4%), frictional keratosis (5.5%), pre-leukoplakia (4.1%), borderline leukoplakia (2.4%), cheek/lip biting (1.3%), and snuff dippers lesion (0.4%). 48.6% of the subjects had at least one of these lesions. Statistically significant preponderance was demonstrated for oralleukoplakia, palatalkeratosis, leukoedema and frictional keratosis among males and melanosis among females. With regard to clinical classification of oral leukoplakia, the prevalence was 10% for homogeneous and 0.6% for nonhomogeneous lesions. On the basis of aetiological classification; the prevalence was 8.3% for tobacco associated and 2.2% for idiopathic leukoplakia. 22.5% of leukoplakia lesions biopsied had evidence of epithelial dysplasia. In view of the premalignant potential of oral leukoplakia, our findings suggest a need for greater attention towards prevention and control of this lesion in the study community.