Oral epithelial dysplasias (OEDs) are potentially malignant disorders characterized by diverse degrees of cellular atypia. The early and careful diagnosis has extreme importance, allowing prevention of the progression to the oral squamous cell carcinoma. This study aimed to determine the epidemiology and then correlate it with the clinicopathological features of OED. One hundred seventy-three cases of oral lesions retrieved from the files of a Service of Pathological Anatomy, covering a 38-year period, were submitted to descriptive statistical analysis through the Pearson χ(2) test. The majority of cases were from affected females (57.9%), with a peak of occurrence in the age group of 41 and 55 years (37.3%), white patients (64.8%), and those with lesions located on the gingiva/alveolar ridge (25.1%). The lesions predominantly presented with white color (56.8%) and were described as nodules (27.4%), with a rough surface (76.7%), an exophytic growth (79.1%), and a sessile base (95.6%). The majority of the lesions with degree of mild (34.6%) and moderate (34.9%) OED had clinical diagnosis of leukoplakia, whereas 33.3% of the lesions with degree of severe had clinical diagnosis of squamous cell carcinoma (P < .05). Tobacco use was the risk habit more related with OED (42.6%) (P > .05). The knowledge of OED epidemiology and clinical features provide a better understanding of the factors that possibly are associated with the malignant transformation of OED. Furthermore, these results contribute to supporting a prompt and accurate recognition of these lesions in clinical practice.