Background: The prevalence of oral lesions in the Republic of Kiribati, a nation in the Pacific, is unknown. This is the first report to describe a case series of oral lesions in Kiribati. Materials and Methods: All the surgical pathology specimens from Kiribati were evaluated at the Gold Coast Hospital in Gold Coast, Australia starting from 2003. Oral lesions which were sent over 4-years period (2003 2006) from Kiribati to Gold Coast Hospital were reviewed. Results: Over the 4-year period (2003 2006), 15 patients (9 men; 6 women) with oral lesions were reported. They accounted for 5% of the 304 pathological specimens received in the period. The average age of these patients was 47 (range 12 to 75). After histopathological evaluation, five cases were cancers. There were 4 squamous cell carcinomas and 1 verrucous carcinoma. Two of the squamous cell carcinomas were the tongue, one in the alveolar and one in the lip. The verrucous carcinoma was noted in the oral mucosa. The benign oral lesions included 8 squamous hyperplasias/fibroepithelial polyps, 1 mucocele and 1 lymphoepithelial cyst. Discussion and Conclusions: The epidemiological data regarding oral lesions in Kiribati are influenced by limited access of the population to surgery. This is the first series to document the high prevalence of oral lesions and also the pathology of these lesions in Kiribati. Further studies are needed to define the extent of these oral lesions, with clinical follow-up to assess survival and response to treatment in Kiribati.