Background and Aim: Ossifying fibroma (OF) is a benign fibro-osseous lesion, which is usually diagnosed between the ages of 20 and 40 years. The female to male ratio is 5:1, with affinity for posterior mandibular region. The aim of the present report is to discuss a case of OF and its clinical, radiological and pathological characteristics and the related surgical approach.

Case presentation: A left mandibular impacted premolar with an associated lesion was incidentally found on a radiograph of a 27-year-old woman. The patient did not report any clinical symptoms. Inferior alveolar nerve involvement by the lesion was obvious in radiographic study. The tooth was extracted and the associated lesion was enucleated under general anesthesia through step-by-step surgery and after releasing the inferior alveolar nerve.

Conclusion: Surgical treatment of Ossifying fibroma consists of enucleation and curettage in small and well-defined lesions, while larger lesions are usually resected. Prognosis is good with a low recurrence rate even with enucleation and after long-term follow-up.