Background: Oral cancer remains a major public health concern in India, particularly in regions where tobacco use-both smoking and smokeless-remains deeply embedded in cultural practices. Shimla, a high-altitude district in Himachal Pradesh, presents a unique epidemiological context due to its rural predominance, traditional habits and limited access to specialized oral healthcare. Despite national awareness campaigns, late diagnosis of oral cancer persists, often due to gaps in public knowledge, misconceptions about early symptoms and inadequate preventive health behavior. Materials and Methods: This cross-sectional, descriptive study was conducted between January and March 2025 among 400 adult residents of Shimla. Using a structured, bilingual (Hindi and English) online questionnaire, data were collected to evaluate socio-demographic variables, knowledge of oral cancer symptoms, risk factors, screening practices and perception-related behaviors. Respondents were categorized into four knowledge levels based on their awareness scores. Descriptive statistics were used for data analysis, with attention to demographic variations and gaps in knowledge. Results: The study revealed that 81.0% of participants correctly identified oral cancer as a malignancy of the mouth or throat and 80.0% recognized smoking as a major risk factor. High awareness was noted for symptoms such as non-healing mouth ulcers (84.0%) and for other contributing factors like alcohol use (77.0%), HPV (75.0%) and betel quid chewing (76.0%). However, awareness was lower for early asymptomatic presentation (72.0%), voice changes (68.0%) and recurrence risks (65.0%). Knowledge levels were generally strong, with 37.5% demonstrating very good awareness and 39.5% falling into the good knowledge category, though 23.0% of respondents exhibited only fair or poor understanding. Conclusion: While the foundational knowledge of oral cancer among Shimla residents is encouraging, significant gaps remain in recognizing less visible symptoms and understanding the full disease trajectory. These gaps are more prominent among individuals with lower education or residing in rural settings. To combat this, tailored, grassroots-level interventions are essential-focusing on culturally sensitive messaging, community health worker engagement and the integration of oral cancer awareness into routine dental care and school-based programs.