The present study was undertaken to assess the prevalence of oral lesion and knowledge regarding oral cancer among auto rickshaw drivers in Changanacherry taluk. The objectives of the study were to assess the prevalence of oral lesion, the level of knowledge among auto rickshaw drivers regarding oral cancer and to associate the prevalence of oral lesion with knowledge level, personal habits and selected demographic variables. Descriptive survey design was adopted for this study. Using convenient sampling technique, 200 auto rickshaw drivers were selected from Changanacherry taluk. Informed consent was taken and data was collected using structured questionnaire on socio demographic and knowledge variable. Structured rating scale is used to assess the personal habits and observational checklist for oral lesion. Data analyzed and it revealed a prevalence of oral lesion is 19% among the subjects. Out of these 28.94% subjects have erythroplakia, 18.42% have leukoplakia, 2.6% have erythroleukoplakia, and 23.68% have painless ulcer more than 3 months. Study could not establish any association between oral lesion with knowledge level and socio demographic variables. Among the subjects 47.5% have poor knowledge,50% have average knowledge and 2.5% have good knowledge regarding oral cancer Binary logistic regression is used to predict risk of personal habits such as smoking  (p=0.001 OR=3.4, 95% CI=1.6–6.9), intake of alcohol (p<0.001 OR=13.7   95% CI=4.6–40.5), chewing pan masala/tobacco in any forms (p<0.001  OR=37.9  95% CI=14.1–101.8), sniffing(p=0.009  OR=3.8  95% CI=1.3–11.1),intake of pickles (p=<0.001  OR=3.4  95% CI=0.7–15.2) and intake of salted fish(p<0.001  OR=1.3  95% CI=0.5–3.28) for oral lesion and these variables have significant association with oral lesion. An informative pamphlet regarding oral cancer is provided to the subjects after the data collection.