Oral submucous fibrosis(OSMF) is well recognized as one of the most common potentially malignant condition of the oral mucosa in India related to chewing of arecanut products and characterized by mucosal rigidity of varying intensity caused by fibroelastic changes of the juxta-epithelial layer, resulting in a progressive inability to open the mouth. The present study aimed to measure submucosal thickness by high frequency ultrasonography (USG) transcutaneously in both cases and controls and to correlate with clinical and histological severity of the disease and the echogenicity pattern. We conducted a hospital based cross sectional study of 20 subjects who were clinically and histopathologically proven to have OSMF and 20 controls matched for age, sex and body mass index. Transcutaneous imaging of the buccal and labial submucosa was performed and the values were correlated with clinical stage and histological grade of the disease. Cases had increased submucosal thickness when compared to controls at all measured sites.To the best of our knowledge, this is the first study to use USG to measure the thickness of submucosal fibrosis in OSMF.