Actinic cheilitis (AC) is a potentially malignant disorder of the lip caused by chronic exposure to ultraviolet radiation. This study aimed to report a case of AC with high-grade epithelial dysplasia submitted to a conservative treatment. Patient E.F.N.F., a 50-year-old man with melanoderma, sought dental care because of the presence of a lesion in the lower lip with a history of about 6 months. He denied painful symptoms. On clinical examination, fissures, edema, and presence of nonraised ulcer showing reddish central area and leucoplast peripheral region were observed in the lower lip. The patient was advised to undergo diagnostic biopsy. The anatomopathologic report resulted in AC with high-grade epithelial dysplasia. He was advised to use hats in addition to moisturizer and sunscreen. After 2 months significant regression of the ulcer and improvement of lip edema was observed. Currently, the patient is in observation, and reviews are made every 3 months. Actinic cheilitis (AC) is a potentially malignant disorder of the lip caused by chronic exposure to ultraviolet radiation. This study aimed to report a case of AC with high-grade epithelial dysplasia submitted to a conservative treatment. Patient E.F.N.F., a 50-year-old man with melanoderma, sought dental care because of the presence of a lesion in the lower lip with a history of about 6 months. He denied painful symptoms. On clinical examination, fissures, edema, and presence of nonraised ulcer showing reddish central area and leucoplast peripheral region were observed in the lower lip. The patient was advised to undergo diagnostic biopsy. The anatomopathologic report resulted in AC with high-grade epithelial dysplasia. He was advised to use hats in addition to moisturizer and sunscreen. After 2 months significant regression of the ulcer and improvement of lip edema was observed. Currently, the patient is in observation, and reviews are made every 3 months.