Ossifying fibroma is benign, usually slow-growing tumor that may behave in an unpredictably aggressive fashion. Most of these unusual tumors affect the mandible. Their behavior in the mid-face and paranasal sinuses is not well documented. In our review of the subject, and of the cases presented, it appears that these lesions behave more aggressively than their mandibular counterparts. A more aggressive approach may be more beneficial than expectant observation or curettage in the initial management of this neoplasm.