Aims: To determine the prevalence and oral effects of betel nut habit among high school in Ahmedabad, Gujarat, India. Methods: Study was carried out in 4000 high school children from different zones of Ahmedabad city. Demographic details and clinical data with their socio economic status and chewing habit were recorded. Results: 912 teenagers had habit of only betel nut chewing of different brands with overall prevalence of 22.8% and habit was more prevalent in boys as compared to Girls. More than 50% of boys the habit was initiated at the age of 13 years and habit were common in middle and high class groups of teenagers which were highly significant. Brand III was more favorite in high class group while brand I and brand II were favorite in middle and poor class group of teenagers. Teenagers of south zone where of poor and middle class group resided were more prone to habit. 70% of them preferred brand I and II while brand III was somewhat equally preferred in other 3 zones which were highly significant. Betel nut chewer shows extrinsic stains and dental decay and Brand III chewer had more deleterious effect on teeth as compared to brand I and II. Conclusions: This study confirmed the need for a preventive motivation in school children not to initiate betel nut habit and alarm them the potential health risks and effects on aesthetics of this substance by conducting the educational school health programs at regular intervals.