Oral cancer being the sixth most common malignancy over all in the world. Most common risk factors as we learnt are synergistic effect of smoking and alcohol though separately smokeless and smoking tobacco poses threat towards developing malignancy. Prevention and early detection of malignancy can cause reduction in mortality and improve patients’ life expectancy. Efforts are being made to come out with new the technologies and biomarkers just to detect the genetic and molecular alterations that normal mucosa undergo during carcinogenesis. Here in this review we will discuss about factors affecting oral carcinogenesis, field cancerization, biomarkers regarding oral carcinogenesis and treatment plan.