Introduction: Malignancies in the oral cavity poses significant health burden in Sri Lanka and demonstrate an increasing trend. The aim of this study was to analyze the characteristics of patients with oral cavity malignancies presenting to a tertiary care center during 2020-2022.Methodology: Hospital records of patients diagnosed with primary oral cavity malignancies presenting to the Dental Teaching Hospital Peradeniya were entered by two investigators to Microsoft Excel spreadsheet according to the National Cancer Control Program format. Descriptive data analysis was conducted using Microsoft Excel software.Results: A total of 193 patients were reported during this period, approximately 9 patients per month. Mean age and standard deviation of the cohort were 61±13 years. The male to female ratio was 2.8:1. There were a total of 17 histological types of malignancies, the commonest being squamous cell carcinoma 74.1%. From the total, 50.8% were diagnosed at advanced clinical stages. The commonest anatomical locations of malignancies were buccal mucosa 36.5% followed by border of the tongue 18.8%. Surgical resection was offered for 163 (84.4%) patients, while 5 (2.6%) received surgery and radiotherapy, and one (0.5%) received surgery and chemotherapy.Conclusions: Male gender, older age group and low socio-economic status were common among patients with oral cavity malignancies in Sri Lanka. The commonest location was buccal mucosa while commonest histological type was squamous cell carcinoma. Late diagnosis remains a major barrier in managing oral malignancies in the country.