A 28-year-old woman presented with a 9-month history of progressive right-sided facial swelling. A transoral incisional biopsy was performed at a community hospital and was suggestive of ameloblastoma. The patient subsequently presented to our center for further management. X-ray (A) and CT scan (B) demonstrated a multiloculated mass extending from the ascending ramus to the body of the mandible but not involving the temperomandibular joint. The extent of this mass was readily appreciated on 3-dimensional CT reconstruction (C). She underwent a right hemimandibulectomy with an immediate right fibular myosseous free flap microvascular reconstruction from a right leg donor site. Grossly the specimen showed a 6.0 2.0 3.5-cm mass involving the ramus of the right mandible. On sectioning, the mass had a multicystic appearance and histology was suggestive of an acanthomatous variant of ameloblastoma. The postoperative course was uneventful and the patient was discharged home on postoperative day 13. She was subsequently fitted with a partial lower denture and 20 months postoperatively she remains disease free and reports a good functional outcome. Ameloblastoma of the jaw is a rare odontogenic tumor. A review of 3,677 cases reported over 33 years in the world literature has been previously published. Ameloblastomas tend to present in young patients (average age 36 years) as a painless slow-growing mass in the molar region of the mandible. Radiographically they can be classified as unicystic or multicystic. Unicystic lesions have a higher recurrence rate than multicystic lesions. On histopathologic assessment one-third are plexiform variants, one-third are follicular variants, and one-third are other types. Follicular variants recur more commonly than plexiform variants. Surgery is the therapy of choice for these tumors and the role of chemotherapy or radiotherapy in disease management is limited. Vascularized fibular free flap microvascular reconstruction can offer these patients an excellent aesthetic and functional outcome.