The variation from the normal color of oral tissues should always attract one's attention, as a proportion of these changes may indicate potential underlying pathology. As the diagnosis of pigmented lesions in oral cavity and perioral tissues is difficult, even epidemiology may be of some help in orienting clinicians. The definitive diagnosis usually requires biopsy and histopathologic examination of the lesion. Thus, an understanding of various disorders and substances that can contribute to oral and perioral pigmentation is essential for appropriate evaluation, diagnosis, and management of patient.Evaluation of the patient presented with pigmented lesions should include full medical and dental history, extraoral and intraoral examination, biopsy and laboratory investigations.