Objective: To determine the prevalence of oral mucosal lesions among smokeless tobacco users of Pakistani Population. Material and Methods: A cross-sectional study was conducted for a period of six months (from July 2017 to January 2018) at Dental Outpatient department of Sindh, via aid of a validated custom-made questionnaire. Random sampling technique was adopted among patients attending dental Outpatient Departments, making use of OPEN API online software determining sample size as 289, with limitation included exclusion of pregnant women, edentulous individuals, children under age of 18 years and those having oral manifestations associated with any systemic disease. Statistical analysis included Logistic Regression and Chi-square for determining odds' ratio and possible associations. Results: Logistic regression model 71% predicted discoloration of buccal mucosa 206 times in absence of any predictor variable. Discoloration of oral tissues was prevalent among individuals who chewed tobacco at least 6 times or more in a day. Periodontal associated damage was also prevalent among 6 times/day and more tobacco chewers. Statistically significant values were for normal buccal mucosa 06-10 times (p=0.007), white patch on buccal mucosa 11-15 times (p=0.0043) and swelled buccal mucosa 11-15 times (p=0.002). Conclusion: This study has demonstrated specific smokeless tobacco associated oral lesions. Further studies nationwide, addressing attributes of socioeconomic status and ethnicity with respect to composition of smokeless tobacco will reveal more conclusive findings.