Proliferative Verrucous Leukoplakia (PVL) is an aggressive form of leukoplakia with a high recurrence rate and potential for malignant transformation. This type of condition needs to be followed up closely with early and aggressive treatment. The gingiva is frequently involved, but other sites may be affected as well. Unlike leukoplakic lesions, PVL exhibits persistent growth with verrucous appearance. Malignant transformation of PVL usually happens in two stages. The first stage of PVL could be indistinguishable from verrucous carcinoma. The second stage is the development of dysplasia and transformation into squamous cell carcinoma.