The following case report illustrates a rather rare oral lesion, an extracranial meningioma. In the dental office the lesion was seen on a periapical x-ray film as a multilocular radiolucency. The patient, however, could not be convinced of the necessity of biopsy until several years later when clinical expansion of the maxillary buccal plate was noted. Thereafter, clinical, radiographic, and histopathologic examination revealed a diffuse meningioma involving the maxillary sinus, the floor of the nose, and the maxillary gingiva. The patient has since refused complete surgical removal but remains alive and well 8 years after the lesion was first noted.