Background: Since the earliest days of medicine, the tongue has been considered a good reflection of systemic disease. Hippocrates, Galen and others considered the tongue to be barometer of health. In addition, the early diagnose of tongue lesions help to recognize the some systemic diseases. The purpose of this study was to determine the frequency of different morphological variations (anomaly) of the tongue in a population of school children aged 6-12 years in Hamadan, Iran. Method: This cross sectional study was held with questionnaires and face-to-face interview among 1600 schoolchildren 6- 12 years old (800 girls, 800 boys) with cluster randomize method were selected and examined. Each school was considered as a cluster that was selected by randomized selections in view of the total sample size. Results: Tongue lesions were found in 39.7% of the children. Overall, the most frequent condition was geographic tongue (27%) and fissured tongue (12.9%). Microglosia and median rhomboid glossitis were in 0.2% of cases. Conclusion: The present study indicates a higher frequency of tongue abnormalities specially geographic tongue than previous studies however further investigation are required to indicate if hereditary and congenital factors play a vital role or if the environmental factors in this region vary with those in their regions. On the other hand the findings from this survey should serve as a baseline for future studies.