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Primary xanthomas of the mandible and maxilla, or primary intraosseous xanthomas of the jaw are exceptionally rare with only 36 cases previously reported. We present another case of a primary xanthoma of the mandible in where a novel approach was used. A conventional sagittal split osteotomy was performed for wide access and a complete enucleation of the lesion and curettage of the adjacent bone was performed. At 1 year follow-up, the patient showed evidence of full healing with no signs of recurrence found clinically or radiographically.