Apocrine hidrocystoma is an uncommon benign cystic proliferation of the apocrine sweat glands. Malignant melanoma, eccrine hidrocystoma, angioma, and follicular cysts have to be considered as differential diagnoses. A 63-year-old man is presented with a dark mass measuring 2 x 2 cm on his right cheek. An exocrine tumor or, more unlikely, a melanoma was considered as a differential diagnosis. Pathologically, the lesion was determined to be an apocrine hidrocystoma. This benign lesion can be excised by a narrow margin. Therefore, knowledge of this benign entity in head and neck surgery including the differential diagnosis can prevent an unnecessarily large defect by too large margins.