Aim: To assess the chromosomal damage and apoptosis in exfoliated buccal cells of individuals with potentially malignant lesions and oral cancer. Materials and methods: Our study included 90 subjects which were divided into three groups of 30 each, Group A-potentially malignant disorders, Group B-Oral cancer and Group C-control. Results: A significant increase in the frequency of micronucleated cell from lesions than in cells from normal areas. We also observed a gradual decrease in apoptosis from normal mucosa to precancerous lesions to carcinoma. Conclusion:Thus oral cancer is associated with a very high frequency of chromosomal damage and impaired apoptosis in the exfoliated buccal cells. Perhaps, beside the micronucleus assay, the inclusion of degenerative nuclear alteration indicative of apoptosis can be a useful tool for biomonitoring oral cancer patients.