The majority of sexually active individuals becomes infected with human papillomavirus (HPV) at least once in their lifetime. Pathways for HPV transmission vary across different mucosal sites per individual. They include autoinoculation within one host, direct transmission between individuals (including perinatal transmission and transmission during sexual activity), and indirect transmission through contact with hands. The authors aim to clarify the prevalence and route of transmission per anatomic site, inter-and intra-individually, using a narrative review of the literature.In conclusion, transmission of HPV to the oral cavity and oropharynx is hypothesised to occur mainly through sexual contact. Transmission of particles through saliva has not been proven and daily living activities are not a documented source of HPV infection. Oropharyngeal HPV related cancer survivors and their partners do not show increased risk of infection during sexual intercourse. Transmission of HPV to the oral cavity (autoinoculation with fingers or transmission through saliva in deep kissing) is probably of limited importance. K E Y W O R D S extragenital → extragenital, extragenital → genital, genital → extragenital, genital → genital, human papilloma virus, mucosal squamous cell carcinomas, orogenital transmission concerns 1 | INTRODUCTION This article will review the known pathways of transmission and clearance of oral human papilloma virus (HPV) infection. The problem of orogenital transmission concerns very sensitive personal spheres of life and is therefore often unexplored in literature. Furthermore, the literature data on the upper airway clearance mechanisms are still scarce and scattered. In this article we describe the risk of HPV transmission to the oropharynx per pathway (autoinoculation, perinatal transmission, inter-site transmission between individuals) as well as the prevalence of simultaneous occurrence of the same type of HPV in different anatomical sites in sexual partners (concordance).A significant proportion of mucosal squamous cell carcinomas of the head and neck, particularly of the oropharynx, are directly attributable to the HPV. 1,2 HPV infection is considered the most common sexually transmitted disease among both males and Abbreviations: DNA, deoxyribonucleic acid; HIV, human immunodeficiency virus; HPV, human papilloma virus; HPV-OPC, human papilloma virus associated oropharyngeal carcinoma; HR-HPV, high-risk human papilloma virus; LR-HPV, low-risk human papilloma virus; MHC, major histocompatibility complex; MMP-8, matrix metallo-proteinase-8; OPC, oropharyngeal carcinoma; RRP, recurrent respiratory papilloma.