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Background: Lichenoid reactions are defined as a group of lesions that have different etiologies, but present with similar clinical and histopathological manifestations. The aim of this study was to determine the frequency of types of oral lichenoid lesions recorded in the Pathology Department of the Dental School, Isfahan University of Medical Sciences, Isfahan, Iran, during a thirty-year period to evaluate the clinicopathological characteristics of these lesions. Methods: This study was performed on 1060 records of patients with lichenoid lesions referred to the Pathology Department of Isfahan School of Dentistry from 1989 to 2018. The obtained data were analyzed using descriptive statistics, chi-square test, and one-way analysis of variance (ANOVA). P values of less than 0.05 were considered significant. Findings: From all 11964 samples recorded in the archives, 1060 cases were related to the lichenoid reactions. Among these lesions, the frequency of oral lichen planus was 39.2%, lichenoid lesions 42.5%, lichen planus or undiagnosed lichenoid lesions 15.5%, and with no definitive diagnosis 2.7%. The most common site of involvement was the area of the cheek. The mean age of the patients was 47.65 ± 13.59 years. There was a significant relationship between the incidence of lesions and gender; the incidence among the women was higher than that of men (P = 0.041). Conclusion: Considering the general frequency of these lesions compared to all oral biopsies (8.85%) and malignant changes risk that in our study is reported as 2.7%, understanding the epidemiological features of these lesions that leads to a better differential diagnosis and treatment is necessary.