Recent technological advances have made saliva as a tool for diagnosis of many things; among them are hormone imbalances, liver function, immunodeficiency and even cancer.Aim:The present study was done to evaluate the levels of copper and zinc and copper/zinc ratio in saliva of premalignant and malignant lesions of oral cavity, because of the anatomical proximity of the saliva to both premalignant and malignant oral neoplasms.Materials and Methods:The levels of copper and zinc were estimated in the saliva of 5 patients with oral submucous fibrosis, 5 patients with oral leukoplakia, 5 patients with oral lichen planus and 10 patients with oral squamous cell carcinoma of oral cavity using inductively coupled mass spectrometry (ICP- MS). The values were compared with 6 normal age and sex matched control subjects.Results:There was significant difference of the mean salivary copper and zinc levels of premalignant and malignant lesions when compared to the normal controls. In oral cancer patients there was significant difference in the copper levels according the histodifferentiaton in squamous cell carcinoma. Within the premalignant group the copper levels were more in the oral sub mucous fibrosis when compared to the leukoplakia and lichen planus. Copper zinc ratio decreased in premalignant and malignant group when compared to the normal group.Conclusions:Saliva may be used as a potential diagnostic tool, which can be efficiently employed to evaluate the copper and zinc levels in pre malignant and malignant lesions of oral cavity. Key words: Copper, inductively couples mass spectrometry, leukoplakia, lichen planus, oral squamous cell carcinoma, oral submucous fibrosis, saliva, zinc