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An 86-year-old man presented with a painful lesion on his left tongue measuring 0.6 x 0.6mm (A). The lesion has been growing over the last 2 weeks. The patient did not remember any trauma except that his teeth did sometimes scratch his tongue. Histology form the excised lesion revealed a pressure ulcer (B). Tongue ulcers can be caused by accidental bites, ill-fitting dentures, braces, citrus or acidic fruits and by a sharp tooth surface. In some other cases nutritional problems such as vitamin B12, iron or folic acid deficiency may cause tongue ulcers. Never the less malignancy needs to be excluded. Therefore, complete excision and diagnosis based on histology is recommended.