Background and Objective:In Tanzania, roughly 6% of the total population is elderly, which is the age group that is vulnerable to several diseases in the orofacial region. This study aimed to determine the incidence of oral and maxillofacial lesions in elderly Tanzanian patients.Material and Methods:This was a cross-sectional study of histopathological results of patients with oral and maxillofacial lesions attended at Muhimbili National Hospital. All patients aged 60 years and above diagnosed with oral and maxillofacial lesions between 2016 and 2021 were included in the study. The information gathered included the age and sex of the patients, histopathological diagnosis, and anatomical location of the lesion. The Statistical Package for the Social Sciences, version 26 computer program was used for data analysis.Results:A total of 348 histopathological reports of 348 elderly patients with oral and maxillofacial lesions were obtained. There was an equal distribution by sex. Majority (78.2%) of the lesions were malignant, followed by benign ones (12.6%). The frequently affected site was the tongue (18.1%) and the mandible (15.4%). Squamous cell carcinoma was the most (60.3%) frequently encountered lesion. Others included adenoid cystic carcinoma (5.5%) and ameloblastoma (3.7%).Conclusions:The burden of oral and maxillofacial lesions among the elderly Tanzanian population was substantial. There was no sex predilection. A majority of the lesions were malignant, and the tongue was the frequently involved site.