Verruciform xanthoma (VX) is a rare benign lesion of oral mucosa. It has an unclear etiology, and it mainly occurs in the oral cavity; however, it can be found in other locations as well. Oral VX is often clinically confused with papilloma, leukoplakia, condyloma, verruca vulgaris, verrucous carcinoma, or squamous cell carcinoma; therefore, biopsy is required to accurately diagnose this lesion. Our study reports four cases of oral VX with different clinical features but similar histopathological characteristics to emphasize the importance of differential diagnosis.