Oral squamous acanthoma (OSA) is an uncommon benign epithelial lesion of the oral cavity, presenting as a solitary, painless, sessile or pedunculated mass. It is considered a variant of oral squamous papilloma, characterized by acanthosis without papillomatosis. Although typically asymptomatic, OSA can cause discomfort or functional impairment depending on its size and location. Diagnosis is primarily based on clinical and histopathological examination, with characteristic features including hyperkeratosis, acanthosis, and elongated rete ridges. Treatment involves conservative surgical excision, with a low recurrence rate reported in the literature. Here, we present a rare case of OSA in a 55-year-old female patient, highlighting its clinical and histopathological characteristics, differential diagnosis, and management. This case underscores the importance of considering OSA in the differential diagnosis of oral lesions and the significance of histopathological analysis in confirming the diagnosis.