© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Objective: To determine the clinical diagnostic accuracy of Narrow Band Imaging™ for the detection of oral potentially malignant disorders in a prospective series of patients. Materials and Methods: New and existing patients referred to an oral medicine and pathology specialist clinic for assessment of at least one white, red or red-white oral mucosal lesion underwent conventional oral examination, followed by examination with the white light mode and then narrow band imaging mode of a Narrow Band Imaging™ system. The clinical presentation, microvascular architecture and relevant histopathology of all lesions were recorded. Results: A total of 272 lesions from 95 patients were observed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the detection of oral potentially malignant disorders or worse by Narrow Band Imaging™ were 100%, 74.63%, 92.38%, 100% and 93.77%, respectively, when compared with conventional oral examination. Narrow Band Imaging™ aided the detection of 24 lesions undetected by conventional oral examination and 13 lesions undetected by white light endoscopy. Conclusion: Narrow Band Imaging™ demonstrates great utility as a visualisation adjunct for detecting and monitoring oral potentially malignant diseases, particularly lesions not identified by conventional oral examination or white light examination alone.