Squamous cell carcinoma (SCC) of the oral cavity can mimic a myriad of ulcerative lesions in the mouth. This is particularly true for medically complex patients who due to their underlying systemic condition and multiple use of drugs, are prone to oral lesions. With increasing dental awareness, more patients are presenting early to the oral surgeons. The era of patients presenting first to the clinician with characteristic fungating solitary ulcer in the mouth with rocky hard submandibular lymph node involvement may be fast disappearing. The aim of the present report is to present a female patient with multiple focal area of erythema on the right lateral border of the tongue which though appeared innocuous but was discovered to be SCC after punch biopsy. High index of suspicion with proper attention to clinical details will be necessary for early diagnosis of SCC in the oral cavity, and therefore improve the overall prognosis of the patient.