Lichen planus of the oral cavity produces significant functional and symptomatic problems for elderly patients. Oral lesions often occur in the absence of concomitant skin lesions. Unlike cutaneous lesions, oral lesions of lichen planus may become a chronic, recurring problem that is difficult to control. The diagnostic features of lichen planus of the oral cavity are reviewed and treatment strategies presented. Periodic follow-up is recommended to monitor the disease process and to observe for the development of early squamous cell carcinoma.