Oral submucous fibrosis (OSMF) is a premalignant condition that has received considerable attention in the recent past because of its chronic debilitating and resistant nature. Over the past decades, dental researchers have reported overwhelming evidence about various etiological factors of OSMF. It has been the subject of controversy ever since Schwartz first described the condition in 1952. Areca nut is considered the primary etiology along with other local irritants like capsaicin, pungent and spicy food, nutritional deficiency, defective iron metabolism, collagen metabolic disorder and genetic predisposition. Association of iron deficiency anemia and OSMF is very sparse in literature. Here, we present a case report of a 58 year old male patient where the patient presented with OSMF where iron deficiency anemia was found to be the main etiological factor.