Objective: The aim of this study was to assess the prevalence and intraoral distribution of oral mucosal lesions in a representative adult population (Study of Health in Pomerania/Germany). Method and Materials: The study sample comprised 6,267 randomly selected subjects who were scheduled for examination from 1997 to 2001 (population-based cross-sectional study; response rate: 69%; age range 20 to 81 years). Results: The prevalence of oral mucosal lesions was age dependent (5.56% in 20- to 29-year-olds to 19.55% in 70- to 81-year-olds) with an overall prevalence of 11.83%. The prevalence in men (12.20%) was slightly higher than in women (11.40%). Exophytic neoplasia was the most prevalent alteration (3.00%), followed by leukoplakia simplex (prevalence 2.85%). Premalignant lesions were found in 0.57% of the participants, with lichen ruber mucosae contributing the major part (0.48%). Exophytic neoplasia was most often situated in the buccal mucosa, the hard palate, or the mucosa of the lower lip. Conclusion: These data stress the importance of screening for oral mucosal lesions, especially because of a predicted increase in the number of elderly persons in industrialized countries. Keywords: distribution, oral mucosal lesions, prevalence, representative survey