This study describes the distribution of type 1 and type 2 blood group carbohydrate chains in human normal and pathological odontogenic epithelia and in epithelia of human oral mucosa. Odontogenic epithelium was examined from 12 fetal tooth germs, 25 ameloblastomas, 13 odontogenic keratocysts, 13 follicular cysts and 13 radicular cysts. Oral mucosal epithelia was studied from 12 fetuses and 10 adults. Cell surface carbohydrates were detected using antibodies with reactivity for the blood group antigens A, B, type 1 chain Lea and type 2 chain H by an immunofluorescence technique. The expression of Lea and H type 2 chain in fetal palatal epithelium and only H type 2 chain in adult palatal epithelium suggests that a change in synthesis of blood group chains occurs during development. Type 2 blood group chains (antigen H) were found in fetal tooth germs, type 1 (Lea) in ameloblastomas and both type 1 and type 2 in odontogenic cysts. These results indicate that a modulation in synthesis of blood group carbohydrates has occurred in ameloblastomas and odontogenic cysts as compared with the cells from which the lesions presumably are developed. It is suggested that ameloblastomas may be distinguished from odontogenic cysts by the inability of ameloblastomas to synthesize type 2 blood group chains and antigens A and B.