Oral cancer is one of the commonest cancer in Indian men (12.6 per 100 000) and common in women also. It is the leading cause of cancer related deaths in Indian men. Internationally it is the eighth most common malignancy reported associated with high mortality rate. It is common among illiterates and those with low income, poor hygiene, poor nutrition and tobacco/areca nut users. Though Oral cancer is one of the best model of screening amongst all human cancers, most of the patients present at a late stage of disease and die in the same year as the year of diagnosis. A cluster randomized trial in south of India showed that screening of oral cancer reduced mortality due to oral cancer in high risk population. The screening test used in that trial was “visual examination by health workers”. Such an intervention is most suited for impoverished nations because it is cheap and reasonably accurate. The sensitivity and specificity are generally of a high order with the pooled average of six studies have yielded a reasonable sensitivity and specificity. The accuracy of the visual inspection can be improved by appropriate standardization and training of the screening individual. Needless to say that, research to develop non invasive diagnostic tools (spectroscopy, salivary test, etc.) that can not only improve but also expedite the diagnosis are need of the hour. It seems that screening and subsequent prompt diagnosis may lead to significant reduction of oral cancer incidence and mortality rate.