This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage tongue ulcer — a case which they are likely to encounter in the future in a general practice setting. It presents the case of a 73-year-old man who presents to his general practitioner because he has problems sleeping. He admits that starting urination has been delayed more often and the stream of urine is not as strong with some dribbling at the end of urination. The doctor proceeds to do a rectal examination and finds an evenly enlarged prostate with a diminished central sulcus. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.