ABSTRACT Aim: To report a rare case of a retained surgical foreign body—a syringe hub with a broken needle—in the mandibular ramus, highlighting its delayed presentation, diagnosis, and management. Background: Retained foreign bodies in the maxillofacial region are rare but clinically important, often resulting from trauma or surgical error. Their detection is challenging, especially in anatomically complex areas like the mandibular ramus, and delayed identification can lead to chronic symptoms. Case Description: A 64-year-old woman presented with pain, restricted mouth opening, and a sinus tract over the left jaw. She had undergone jaw surgery 9–10 years prior. Imaging revealed a metallic object in the mandibular ramus. Surgical exploration confirmed a retained syringe hub with a broken needle. It was successfully removed, and the patient recovered uneventfully. Conclusion: Retained foreign bodies can remain asymptomatic for years and present later with complications. Timely diagnosis requires clinical vigilance and imaging. Clinical Significance: Unexplained symptoms post-surgery should prompt suspicion of retained materials to avoid long-term complications.