Contaldo M, et al. - Researchers conducted this prospective case series to characterize reflectance confocal microscopy (RCM) cytoarchitectural findings in oral mucosae affected by oral squamous cell carcinoma (OSCC) and its precursors. Prior to conventional biopsy and histopathological assessment, a series of clinically suspected oral lesions had RCM imaging to identify suggestive features of tumoral changes. In total, 30 sites in 20 patients were regarded as controlled and clinically categorized as 16 "leukoplakia"/"trauma," nine erosive-ulcerative lesions, three verrucous lesions, and two healthy mucosae. The findings are well associated with histopathology, reporting 1.000 (sensitivity), 0.933 (specificity ), 0.909 (positive predictive value), and 1.000 (negative predictive value) after excluding three verrucous lesions from the RCM assessment owing to low laser penetration through the hyperkeratotic layers. Findings suggested that RCM may show dysplastic/neoplastic signs in oral lesions, thereby promoting the diagnostic pathway.