Abstract Objective This study aimed to analyze the clinical characteristics of oral lichenoid disease and investigate its potential association with systemic diseases. Methods This study was a retrospective cross-sectional analysis. The study comprised 116 patients who had been diagnosed with oral lichenoid disease, including 70 with oral lichen planus and 46 with lichenoid lesions. The study meticulously documented the distribution and types of lesions in oral lichenoid disease patients. Results The average age was 46 years, with females representing 69.8% and males 30.2%. The prevalence of major systemic diseases among these patients was notable: thyroid disorders were observed in 64.7%, dyslipidemia in 44.0%, hyperuricemia in 36.2%, hypertension in 28.5%, and diabetes in 21.6%. Significant associations were found between specific lesion sites and systemic diseases. Network-like lesions in the gingival-buccal groove were highly correlated with thyroid disorders (P