Background: Oral lesions can affect people’s quality of life by interfering with chewing, swallowing, and speech. These lesions may originate from epithelial or mesenchymal tissues. Malignant oral lesions can be life-threatening. Epidemiological data of oral lesions in Iran is limited. Objective: This study aims to investigate the frequency of oral lesions in Rasht, Iran. Methods: In this cross-sectional study, histopathologic data of oral lesions reported by Razi laboratory in Rasht from 2015 to 2019 were evaluated. The data collected: Patients’ age and sex, histopathologic findings, and location, type and origin of lesions. Non-specific diagnoses and dental and bone lesions were excluded. Results: A total of 259 pathologic reports were included. The mean age patients was 52.09±19 years, and 40.2% were male. Oral lesions in patients aged <40 years were mainly benign (64.2%), whereas half of lesions in patients ≥70 years were mostly malignant. Tongue was the most common location of the lesions (34.7%) and the main location for malignant lesions (46.7%). Benign lesions were significantly higher in females whereas malignant lesions were significantly higher in males (P=0.011). Epithelial tissues were the most common site of origin (49%) and salivary glands were the least common site of origin (11.6%) for oral lesions. Conclusion: Malignant oral lesions are more common in Iranian men aged >70 years, where the tongue is the most common site of involvement and epithelial tissue is the main site of origin.