Background: Apoptosis plays an important role in both human embryonic development and adult tissue homeostasis. The most common mechanism by which the body eliminates damaged or unneeded cells without local inflammation from leakage of cell contents. Survivin is an inhibitory of apoptosis protein that can block an apoptotic pathway. Overexpression of survivin has been detected in many human cancers and found to be associated with disease progression, recurrence, low survival and increased resistance to anti-cancer therapies. Material and Methods: Immunohistochemical staining with Streptavidin peroxidase was used to analyze the survivin expression in 25 cases of oral squamous cell carcinoma and 17 cases of premalignant cases. Results: survivin immunoreactivity is directly correlated with grades of malignancy and degree of epithelial dysplasia in premalignant lesions. Survivin immunopositivity was detected in 21/25 (84%) of studied cases of OSCC and in 11/17 (64.7%) of premalignant cases Conclusion: Increased expression of anti-apoptotic survivin in high grade tumors suggests that survivin is likely to contribute significantly to apoptosis resistance in response to therapy.