Osteomas are benign bone tumors commonly restricted to craniofacial skeleton. They occur in 2 distinct forms: periosteal, arising from bone surfaces and endostea, arising from medullary bone. This clinical case presents a white 61-year-old female patient with chewing pain complaint, prosthetic maladjustment, and vestibular bone expansion of the mandible anterior region 5 years earlier. The patient sought a dental implant clinic for oral rehabilitation, and a radiographic examination revealed a single lesion. The patient was referred to a stomatology clinic, and a cone beam computed tomography was requested, which revealed a well-circumscribed hypodense image with a well-defined hypodense halo, suggesting complex odontoma. The patient was submitted for excisional biopsy, and the histopathologic diagnosis was endosteal osteoma. Endosteal osteomas are characterized by slow growth and make differential diagnosis radiographically with sclerotic lesions, such as condensing osteitis, cementoblastoma, and complex odontoma. Histopathologic analysis is important for diagnostic confirmation and adequate management. Osteomas are benign bone tumors commonly restricted to craniofacial skeleton. They occur in 2 distinct forms: periosteal, arising from bone surfaces and endostea, arising from medullary bone. This clinical case presents a white 61-year-old female patient with chewing pain complaint, prosthetic maladjustment, and vestibular bone expansion of the mandible anterior region 5 years earlier. The patient sought a dental implant clinic for oral rehabilitation, and a radiographic examination revealed a single lesion. The patient was referred to a stomatology clinic, and a cone beam computed tomography was requested, which revealed a well-circumscribed hypodense image with a well-defined hypodense halo, suggesting complex odontoma. The patient was submitted for excisional biopsy, and the histopathologic diagnosis was endosteal osteoma. Endosteal osteomas are characterized by slow growth and make differential diagnosis radiographically with sclerotic lesions, such as condensing osteitis, cementoblastoma, and complex odontoma. Histopathologic analysis is important for diagnostic confirmation and adequate management.