Proliferative (verrucous) leukoplakia (PVL) is a clinico-pathologic entity and a particular form of high-risk leukoplakia characterized by white plaques on the buccal mucosa that are persistent, progressive, and often multifocal, that is associated with a high rate of malignant transformation (70% to 100%). Malignancy takes the form of squamous cell or verrucous carcinoma. They begin as white plaques that over years develop exophytic and verrucous areas. However, not all cases of PVL have verrucous areas. There is likely some overlap between lesions of "verrucous leukoplakia" that are generally localized and PVL.

Females are affected 4-5 times more often than men. Since these lesions are progressive, patients often present with a 1-2 decade history of these lesions being present and patients are typically in the seventh decade and older. Unlike localized leukoplakia, tobacco use is noted in less than one-third of cases.