This document summarizes the medical management of oral submucous fibrosis (OSF) in its initial stages. OSF is a chronic disease caused by areca nut use that results in fibrosis of the oral cavity and issues opening the mouth. In early stages, topical corticosteroids can be used, while intralesional steroids and enzymes are used in moderate stages. Supplements like lycopene and vitamins can also be given. Gentle physiotherapy helps in mouth opening. Medical management in initial stages includes counseling to quit habits, topical steroids, supplements and physiotherapy, while later stages may require surgery.