Purpose: Intravascular papillary endothelial hyperplasia (IPEH) is a benign, nonneoplastic, vascular lesion, that is characterized histologically by papillary fronds lined by proliferating endothelium: it is thought to represent an unusual form of organizing thrombus. It may develop in a distended vessel or in association with other vascular lesions. The main significance of IPEH is its microscopic resemblance to angiosarcoma and possible misinterpretation as such. Methods: We report the clinicopathologic features of 18 examples of IPEH of the oral soft tissues and lips, and review such features of 55 previously reported oral cases. Results: The lips and tongue were most frequently involved and a female predilection was evident. Histologically, the pure form of IPEH was more commonly encountered. Conclusion: The differential diagnosis and possible histogenesis of the lesion are discussed.