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Background: Tobacco use in smokeless and smoked forms is preventable cause of mortality and morbidity worldwide. Objective: To determine the prevalence of smokeless tobacco use and the association with tooth loss and oral health problems among adults in Cameroon. Methods: Adults dwelling in the Fokoue area of West Region of Cameroon were studied. Results: Out of the 226 participants studied, 119 of them reported smokeless tobacco use giving a prevalence of 52.7% with majority-74 (62.2%) chewing it. Three-quarters (77.3%) of the respondents use it more than than thrice-daily and more than half of them respondents have been using it for 6-10 years. The smokeless tobacco users were more of those aged 50-59 years, females, farmers, those with less than post-primary education, non alcohol consumers and those that have not received previous dental care than smokeless tobacco users. However, it was only age (p=0.006) and educational attainment (p=0.009) that were significantly associated with smokeless tobacco use. Smokeless tobacco user were more likely to have poor oral hygiene, dental caries, gingival recession, leukoplakia, erythroplakia, abnormal growth, tooth wear lesion, experienced tooth loss and edentulousnss than non smokeless tobacco users. However, the significantly associated lesions with smokeless tobacco use were tooth loss (p=0.008), edentulousness (p=0.016), gingival recession (p=0.006) and leukoplakia (p=0.001). Conclusion: The prevalence of smokeless tobacco use was high among adults in Cameroon and it was associated wit