A 13-year-old female patient was referred by her dentist for evaluation of a 5-mm, asymptomatic, black macule in the right buccal mucosa. The patient was unaware of the lesion, and her medical history was noncontributory. A clinical diagnosis of oral melanocytic nevus was made, and the patient was treated by excisional biopsy under local anesthesia. The histologic analysis revealed a proliferation of nevoid cells, organized in small groups and composed of large epithelioid cells with eosinophilic, clear, or dark-brown cytoplasmic melanin granules presenting loose chromatin, prominent nucleoli, and nuclear pleomorphism. In the deeper areas, fusiform nevoid cells presenting dark nuclei with condensed chromatin and dark brown-pigmented cytoplasm were seen intermingled with dense connective tissue. Mitoses were not detected. Based on the findings, a diagnosis of intramucosal combined nevus composed of Spitz and blue nevus was made. No signs of recurrence were observed after 19 months of follow-up. A 13-year-old female patient was referred by her dentist for evaluation of a 5-mm, asymptomatic, black macule in the right buccal mucosa. The patient was unaware of the lesion, and her medical history was noncontributory. A clinical diagnosis of oral melanocytic nevus was made, and the patient was treated by excisional biopsy under local anesthesia. The histologic analysis revealed a proliferation of nevoid cells, organized in small groups and composed of large epithelioid cells with eosinophilic, clear, or dark-brown cytoplasmic melanin granules presenting loose chromatin, prominent nucleoli, and nuclear pleomorphism. In the deeper areas, fusiform nevoid cells presenting dark nuclei with condensed chromatin and dark brown-pigmented cytoplasm were seen intermingled with dense connective tissue. Mitoses were not detected. Based on the findings, a diagnosis of intramucosal combined nevus composed of Spitz and blue nevus was made. No signs of recurrence were observed after 19 months of follow-up.