Introduction: A young boy presented with mandibular swelling at the Department of Oral and Maxillofacial Surgery in Hospital Leforte, São Paulo, Brazil. Radiography showed a mixed bone lesion. Computed tomography (CT) findings were compatible with ameloblastic fibro-odontoma (AFO). Case Report: An excisional biopsy was performed under general anesthesia. At the 6-year follow-up, local inflammation and mild exudates were found. Local recurrence of the lesion was observed on CT. Therefore, excision and curettage were performed. No signs of recurrence have been detected to date. Ameloblastic fibro-odontoma is a rare benign neoplasm most commonly occurring in the first decade of life, with minimal probability of malignancy. Conclusion: Clinical, radiological, and histopathological findings aid in the diagnosis, and long-term follow-up is necessary as recurrence can develop even after 6 postoperative years.