A series of over 4000 oral mucosal biopsy cases was examined in two age groups, elderly (≥ 65 years) and non‐elderly, and allocated between seven diagnostic categories. The data were analysed against the know age‐sex distribution of the general population of the Mersey Region from which the oral biopsy cases had been drawn. The distribution of diagnostic categories was significantly different between the two age groups. For all diagnostic categories except mucosal cysts (malignant and premalignant disease; benign keratoses; denture‐induced hyperplasia; benign proliferative lesions; lichen planus; and miscellaneous diseases) the age‐corrected prevalence was higher in elderly than non‐elderly with the greatest difference occurring in malignant/premalignant diseases (5.5‐fold higher prevalence in the elderly). The results suggested that in the Mersey Regional population the prevalence of oral mucosal disease, of a type and severity to warrant surgical removal of tissue, was 47% higher in the elderly than the non‐elderly. These results strongly support the notion that age exerts an important influence on the prevalence and pattern of oral mucosal