A three-year-old boy presented with a painless mass in the nasolabial fold and ipsilateral increased tearing. A diagnosis of odontogenic myxoma (OM) was established by biopsy, and the tumour was excised using a combined oral and transconjuctival approach. In small children OM occurs almost exclusively in the maxilla. Orbital involvement is very rare, and to our knowledge reconstruction with a Medpore sheet has not previously been reported. At post-operative follow-up normal eye function and an excellent cosmetic result was observed. OM should be considered in a midfacial mass.