Oral submucous fibrosis (OSF) is a well-recognized chronic insidious disease, precancerous condition, autoimmune and collagen related disorder which is multifactorial in origin mainly associated with the practice of chewing betel quid containing areca nut, a habit common among lower socio-economic strata of society. It is characterized by inflammation, increased deposition of submucosal collagen and formation of fibrotic bands in the oral and paraoral tissues, which increasingly limit mouth opening. In the myriad of literature available, numerous etiology and management techniques are put forward by various authors in the past. In this paper, an attempt is made to analyze critically and update the knowledge of the recent developments that enhances the understanding of the etiology of this premalignant condition and its medicinal & surgical management which improves the life expectancy.