AbstractBackgroundFollicular lymphoid hyperplasia (FLH) is an uncommon benign lymphoproliferative lesion found in the oral cavity, with a particular preference for the hard palate. FLH closely resembles follicular lymphoma in both clinical and histopathological aspects, which may result in misdiagnosis and unnecessary invasive procedures for the patient.AimThis report describes a case of FLH in the hard palate.Materials and MethodsData were collected from the clinical record, and a literature review was carried out over a period of 43 years.ResultsThe literature has documented 27 FLH cases. In this case, an 80‐year‐old woman had painless swelling in the hard palate extending to the soft palate. Histopathological findings suggest FLH with positive immunohistochemistry for CD20, CD10, Ki‐67, and bcl‐2. The patient received conservative treatment and close follow‐up until the lesion completely disappeared.ConclusionThe clinical history was consistent with FLH. Diagnosis is a challenge and relies on closely correlating clinical and microscopic data. Although treatment options range from surgery to a more conservative approach, for elderly patients, the last option could be the safest and most effective.