Tongue diagnosis sits within the observation category of examination and forms one of the four pillars of diagnosis of Traditional Chinese Medicine (TCM). Clinical and educational texts on tongue inspection and diagnosis focus on the appearance of the dorsal surface of the tongue. However what is becoming evident is that this restricted focus is not only limited, but clinically inadequate and likely to overlook significant and even potentially fatal manifestations that are not evident on the dorsal surface but involve instead the ventral and or lateral surfaces of the tongue. Further, the range of diagnostic characteristics associated with the dorsal surface described by TCM texts do not include well documented and obvious manifestations that occur in the general Australian population associated with local and systemic pathology. Some features manifest with occurrence rates of around three to ten percent and vary in their degree of potential severity to health. TCM is in a position to impact positively and significantly on community health care with respect to oral/tongue conditions because the tongue is routinely examined. This however will require improved and extended examination and reporting of tongue features and regions. To this end a new protocol currently being trialled at a Sydney teaching TCM clinic, has been developed to ensure collection of detailed objective records of patients’ tongues and referral procedures as well as developing extensive epidemiological data with in regards to tongue conditions encountered in the clinic setting.