Objective The objective of this study is to observe the clinical and pathological characteristics of oral submucous fibrosis(OSF) coexisting with oral leukoplakia(OLK) to analyze the relationship between the degree of epithelial hyperplasia and the severity of fibrosis. Methods The clinical and pathological data of 74 patients with OSF coexisting with OLK were collected and reviewed. Results Seventy-four patients with OSF coexisting with OLK were mainly young and middle-aged male patients. All had the habit of chewing betel quid, and all exhibited symptoms of OSF and OLK, but higher prevalence is observed in age range of 20 to 49. Pathological features include widened epithelial cell gap, thickened basement membrane, and degenerated collagen fibers. Conclusion No relationship was found between the degree of epithelial hyperplasia and the severity of fibrosis in patients with OSF coexisting with OLK. OSF coexisting with OLK is not simply a combination of two diseases; rather, the combination of which has peculiar features.