In 2017, the United States Food and Drug Administration approved the marketing of the first whole slide imaging system that allows for primary diagnosis of digitized surgical pathology slides prepared from biopsied tissue.1 The College of American Pathologists, in collaboration with the American Medical Association, subsequently created and approved 43 distinct digital pathology digitization procedure codes that have laid the groundwork for eventual reimbursement for these services.2 During the COVID-19 pandemic, the use of digital pathology, including within large academic centers, emerged as a timely and powerful technology for routine primary diagnosis.3 With the continuing evolution and maturation of these technologies and the inevitability that generative artificial intelligence algorithms will eventually be used in histopathologic diagnosis of tissue specimens, it is likely that all realms of diagnostic anatomic pathology will experience a revolutionary change. However, I have particular concerns about the impact this will have on the future practice of oral pathology. In fact, threats from a variety of different directions may imperil the sustainability of oral pathology practice, if not the discipline itself.