Fibromas are the most common soft tissue lesions of the oral cavity and are generally attributed to trauma. Koilocytic dysplasia refers to human papillomavirus (HPV)–related epithelial cytopathic effect. Koilocytic dysplasia is considered neoplastic. Herein, we report a case of oral fibroma with HPV-induced dysplastic changes of the surface epithelium confirmed by immunohistochemical stains for p16 and p53 as well as HPV in situ hybridization.