Fellatio--a sexual act in which the penis is placed into the mouth of another person--can result in submucosal hemorrhage of the palate. A young woman with fellatio-associated palatal petechiae is reported and the features of irrumation-induced oral lesions of the palate are reviewed. Fellatio-associated petechiae and purpura can potentially occur in anyone who engages in receptive penile oral sex. The lesions are asymptomatic and typically appear on the soft palate. Because the fellatrix or fellator may be unaware of the etiology of the lesions or may be reluctant to provide these details of the sexual history, the clinician needs to have a high index of suspicion based on the patient's clinical presentation and collaborating history of preceding fellatio.