Abstract: Leukoplakia is a predominantly white lesion of the oral mucosa that carries an increased risk of malignant transformation. Purpose of Review: (1) To provide insight into the difficulties in arriving at a proper diagnosis, (2) to evaluate the latest research on (bio) markers that may have predictive value with regard to the risk of malignant transformation, and (3) to evaluate the latest research on how patients with oral leukoplakia should be managed. Recent Findings: Research on oral leukoplakia is still very much hampered, mainly because of the rather poor definition. No new (bio)markers have become available that reliably would predict malignant transformation. Surgical and nonsurgical treatments have still not yet been proven to be effective in preventing such transformation. Summary: Only after having solved the shortcomings in the definition and the lack of uniform reporting problem proper, randomized controlled studies on the various aspects of oral leukoplakia can be performed.