Oral leukoplakia is the most common premalignant lesion and malignant transformation has been reported from verrucal lekoplakia. Homogenous, benign leukoplakia develops into a line of squamous cell carcinoma such as verrrucous carcinoma, papillary squamous cell carcinoma and invasive squamous cell carcinoma. Early diagnosis and intervention of premalignant leukoplakia is up-most important to prevent transformation into a oral squamous cell carcinoma. Any change in surface, size and color warrants repeated biopsy. If verrucous carcinoma is evidently derived from the previous leukoplakia, wide surgical excision and periodic follow up is needed. Surgically removed lesion of leukoplakia has the tendency to recur. Follow-up is very important to patient and clinician. Although many therapies have been reported to oral leukoplakia and verrucal carcinoma, accepted treatment principle is not exist so far. But surgical removal is recommended as the treatment of choice.