Oral submucous fibrosis is multifactorial, collagen metabolic disorder caused by chronic areca nut chewing. It is a ‘Potentially Premalignant Oral Epithelial Lesion’ (PPOEL) that could be regressed if diagnosed in the early stages. This study aimed to assess the prevalence of clinical symptoms in Oral Submucous Fibrosis (OSMF) patients who reported to a dental institution. The objective was to evaluate the association of clinical symptoms specific to OSMF with its grading of disease progression. One-year data of OSMF patients (N = 155) were retrospectively collected from the department. The prevalence of the lesion across gender and age was assessed using SPSS software. A Chi-square test was used to measure the association between gender and Chief complaints; grading and chief complaints. 91.89% of males and 8.11% of females had specific chief complaints related to OSMF. Among the symptoms, burning sensation (35.1%) and reduced mouth opening (35.1%) were more prevalent followed by pain in the cheeks (18.9%) and ulcers in the mouth (10.8%). The symptomatic cases were exclusively seen in grades 2, 3, and 4 (Kerr et al. classification). The association between gender and specificity of chief complaints was not statistically significant with a P-Value of 0.63 (P > 0.05). The association between the distribution of chief complaints and grading among OSMF patients was statistically significant with a P-Value of 0.0001 (P < 0.05). OSMF patients report clinical symptoms only at later stages of disease progression, increasing the burden of treatment care for the patient.