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Clinically, extraoral sinus tracts of endodontic origin may be confused with a wide variety of diseases. Thus, the differential diagnosis of this clinical dilemma is of paramount importance in providing appropriate clinical care because misdiagnosis of this condition may result in healing failure or unnecessary treatments. For this reason, a dental cause must be considered for any cutaneous sinus tract involving the face or neck. Its diagnosis is not always easy unless the treating clinician considers the possibility of its dental origin. Once the correct diagnosis is made, definitive treatment, through either tooth extraction or root canal therapy to eliminate the source of infection, is simple and effective.