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We describe an interesting case of oral sub mucous fibrosis accompanied by severe trismus in a 23 years old man. The patient had initially been diagnosed as having internal derangement of the temporomandibular joint and conservative treatment had failed to decrease the symptoms. Despite extremely limited temporomandibular joint movement, cone beam computed tomography revealed no important abnormality. The patient had been referred to Mashhad Dental School for further evaluation. On detailed case history, the patient revealed oral adverse habits such as pan & tobacco chewing and on palpation fibrous bands were noticed on the anterior and some parts of buccal mucosa; therefore, the patient was diagnosed with oral submucous fibrosis and underwent surgical excision of fibrous bands.