Oral cancers commonly develop in people who consume tobacco in various forms and drink alcohol. They are both independent risk factors, but they have a considerable synergistic effect. Various studies have tried to correlate the role of alcohol alone as a causative factor of oral cancer. But it is difficult to establish principally because alcohol consumption histories are subjective and difficult to verify, alter over time, both with respect to beverage type and quantity, and are frequently confounded by tobacco use. Hence there is a need to develop a more objective way of assessing the chronic intake of alcohol. The mean corpuscular volume or "mean cell volume" (MCV) is a measure of the average red blood cell volume and can be used as an objective indicator of alcohol intake. The aim of the study is to emphasize the role of MCV measurement as a new means of predicting risk for OSCC in Indian population. This is a comparative study in which the MCV is estimated in patients of oral cancer with history of both tobacco and alcohol intake and in patients with history of tobacco and alcohol intake without cancer. This article reviews the role MCV as an objective marker in patients with oral cancer and to find out how effective MCV is in assessing the risk of the disease progression.