Oral Submucous Fibrosis (OSMF) is a chronic, insidious, irreversible, progressive, scarring and debilitating potentially malignant disorder (PMD) involving the oropharynx and the upper part of the esophagus. It is characterized by juxta-epithelial inflammatory reaction and progressive fibrosis of lamina propria, leading to blanching, stiffness and rigidity of oral mucosa, and further trismus. OSMF is frequently seen in countries of south and south-east asia. The etiology of this disease is multifactorial, but studies have confirmed its strong association with chewing of arecanut and its commercially available products. The molecular pathogenesis of OSMF is unclear and complex. Hence, the authors through this article are proposing additional information to the existing pathogenesis of OSMF and have made an attempt to simplify the same. This article also highlights the new clinical manifestations of OSMF, observed by the authors.