Background- Oral cancer is one of the most widely prevalent diseases of the world. It is a form of malignant neoplasm found mostly on the lip, floor of the mouth, cheek lining, gingiva, palate or in the tongue. Aim- To assess and compare oral health related quality of life and depressive symptoms among adult patients detected with oral precancerous lesions and a healthy comparison group attending outpatient department of a dental hospital of Dibrugarh district. Methodology- A cross-sectional exploratory study was conducted among 250 adults diagnosed with precancerous oral lesions visiting the outpatient department of Government Dental College, Dibrugarh. The data was recorded by examiner with the help of a pre designed proforma. The proforma recorded the identification and basic demographic variables of the study participants and use of pre-validated Patient Health Questionnaire 9 scale for assessing depressive symptoms and OHIP ‑ 14 tool for assessing the oral health related quality of life. Results- The mean age of study subjects with Premalignant lesions is 45.81 ± 5.05 years whereas of healthy study subjects is 40.85 ± 7.7 years. Majority of the study subjects in both the groups had mild depression symptoms but a few of them with premalignant lesions showed higher values of moderate and moderately severe depressive symptoms when informed about their conditions than the healthy group but it was not statistically significant. Functional limitation (0.715**), physical pain (0.738**), and psychological discomfort (0.819**) had a statistically significant strong positive correlation with their degree of depression, whereas physical disability (0.655**), psychological disability (0.545**), social disability (0.598**), and handicap (0.616**) had a moderate positive correlation with degree of depression. Whereas the healthy comparison group had a negative correlation with oral health related quality of life. Conclusion - The findings of this study highlight importance of early detection, prevention, and prompt management of precancerous oral lesions to enhance the overall well-being of affected individuals.