The term “pigmentation of oral mucosa” is applied to a wide range of lesions or conditions featuring a change of color of oral tissues. Common causes of mucosal coloration including petechiae, purpura, ecchymoses, hematomas, vascular tumors and exogenous substances are not true pigmented lesions. In contrast, melanin which is synthesized by melanocytes, is a true pigment and usually imparts a brown, blue or black appearance of the mucosa. Oral pigmentation affects about 3%of the total population and most likely in those with dark skin, more prevalent in females than males during the 3rd or 4th decade of life. In this review, we are describing the oral manifestation and dental considerations associated with common pigmented disorders which will allow the practitioner to have a holistic approach in diagnosis and management of these patients.