Objectives:To report the prevalence and types of biopsied oral and maxillofacial lesions (OMLs) in South-Western (Jazan Province) region, Kingdom of Saudi Arabia (KSA).Methods:This retrospective study was based on the retrieval of clinicopathological data for a period of 6 years between January 2009 and December 2014. These data were obtained between October 2014 and June 2015 from the histopathology records of King Fahad Central Hospital, Jazan, KSA, which is the only referral center for biopsy services.Results:Out of the 32149 biopsies received, 714 (2.2%) were OMLs. The age ranged from 0 (neonatal) to 100 years, with a mean age of 46.8±23.4 and a male-to-female ratio of 1:1.3. The tongue was the most common site for OMLs and for malignant neoplasms, in particular. The most common category was malignant neoplasm (38.7%), followed by inflammatory lesions (16.5%). Oral malignancies accounted for 15.8% of all malignancies. Oral squamous cell carcinoma (OSCC) (36.1%) was the most frequent type, followed by pyogenic granuloma and mucocele (7% each). Shammah-associated OSCC and epithelial dysplasia were twice as common in females.Conclusion:The number of non-malignant OMLs was much lower than expected in comparison to oral malignancies. This difference can likely be explained by the fact that the biopsies were taken only when malignancy was suspected. The higher rate of OSCC reported from this region is attributed to shammah usage. This study emphasizes the importance of biopsy services for all OMLs and the prevention of shammah use.