Oral cancer is the sixth most common malignancy worldwide with more than 263,000 patients diagnosed in 2008. Nonspecialists' negative attitudes and poor working knowledge of oral cancer significantly contribute to suboptimal detection of early-stage disease which leads to delays in diagnosis. We aimed to assess the working knowledge and views associated with oral cancer prevention among medical students in Saudi Arabia. A cross-sectional questionnaire-based survey of 4th, 5th, and 6th year undergraduate medical students was undertaken. Questions included knowledge of oral cancer, risk factors, and opinions on oral cancer prevention. The overall response rate was 82 % (137/167). Mean score of cancer knowledge was 57.8 % which was below the expected standard of 70 %. Only 53 % correctly answered all questions related to oral cancer. This result had no association with either the academic year (p = 0.23) or gender (p = 0.37). Interestingly, 72 % of the respondents did not feel confident in performing an oral examination. Sixty-three percent of the medical students believed it to be beyond their role to aid patients in smoking cessation measures or to take part in other disease preventative strategies. This study demonstrates a dearth of knowledge relating to the diagnosis and management of oral cancer among clinical students within an established Saudi medical school. An immediate refinement of current medical curricula to address these deficiencies is warranted.