Background: Oral submucous fibrosis (OSMF) is a chronic, potentially malignant disorder primarily affecting the oral mucosa. Buccal pad of fat (BPF) grafting has emerged as a promising therapeutic approach, with recent interest in augmenting its efficacy through the use of bovine collagen membrane (BCM). However, a comprehensive comparative evaluation of BPF with and without BCM in the management of OSMF is lacking.