Background <p>The incidence of oral cancer is significantly increased by a lack of knowledge about its risk factors and early symptoms. This study aimed to assess patients’ knowledge and awareness of oral cancer and precancerous lesions attending the outpatient department of Dhaka Dental College Hospital.</p> Methods <p>A cross-sectional study was conducted among 342 patients aged 18–76 years using convenience sampling. A semi-structured questionnaire assessed knowledge of risk factors, signs and symptoms, treatment, awareness of screening, and sources of information. Continuous data were dichotomized into ‘good’ and ‘poor’ knowledge levels using median splits—an approach that may limit statistical interpretability. A score of ≥ 50% indicated satisfactory awareness.</p> Results <p>A total of 60.5% (207) of respondents demonstrated good knowledge of risk factors, while only 15.5% (53) had good knowledge of signs and symptoms. The overwhelming majority, 95.6% (327), had never been screened for oral cancer despite 88% (301) having a positive attitude toward screening. Pearson’s chi-square test showed statistically significant associations between total mean knowledge and awareness scores with age group and education level (<i>p</i> &lt; 0.05). Television (45.9%, 157) was the major source of information.</p> Conclusion <p>This study identifies important gaps in oral cancer knowledge and awareness. The results indicate that although there is high familiarity with the term “oral cancer”, this may not correspond to actual understanding of symptoms or screening practices. These findings suggest a potential benefit from exploring targeted public health initiatives, incorporating screening into primary care, and leveraging media for education. While convenience sampling restricts generalizability, it highlights the value of using representative sampling in future research.</p>