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Background: Periodic clinical examination of the oral cavity is the mainstay for the early detection of oral cancers which can be further aided by screening individuals with high-risk factors that will identify candidates who should receive treatment to prevent cancer progression and reduce patient mortality. Among the diagnostic tools, in vivo staining is advocated as a simple, inexpensive and fairly sensitive method. Materials and Methods: The present study involved the examination of fifty patients suspected of oral malignant or precancerous lesions by methylene blue staining. The results of methylene blue uptake were compared with a simultaneous biopsy of these lesions, while benign epithelial lesions were included as the negative subjects of screening. Results: The results revealed a sensitivity of 89%, a specificity of 91%, a positive predictive value of 97% and a negative predictive value of 73%. Conclusion: We recommend that methylene blue staining is a useful diagnostic adjunct in a large, community-based oral cancer screening program for high-risk individuals.