Objective To determine the value of transoral ultrasound ( US ) guided biopsy for oral tumors . Methods A consecutive series of 36 patients w ho underwent transoral US‐guided biopsy of oral tumors were evaluated retrospectively . By testing against histopathological results after surgery , the diagnostic sensitivity ,specificity ,positive predictive value ,negative predictive value and accuracy of transoral US‐guided biopsy for oral tumors were calculated . ROC curves were plotted and the area under the curve were evaluated . Results All 36 lesions were successfully performed transoral US‐guided biopsy . T he diagnostic sensitivity ,specificity ,positive predictive value ,negative predictive value and accuracy of this technique for the diagnosis of oral lesions were 87 .0% ,100% ,100% ,81 .3% and 91 .7% respectively . In ROC curve analysis , the area under the curve was 0 .935 . No serious complications were observed . Conclusions Transoral US‐guided biopsy can be considered as a safe and effective technology for early diagnosis and clinical treatment of oral tumors .