Low-grade osteosarcomas of the paranasal sinus are extremely rare. Most reported cases of maxillary sinus osteosarcoma are high-grade. We present a 51-year-old man with a low-grade osteosarcoma which was histologically difficult to diagnose in isolation since it had bland features. The presence of an aggressive destructive lesion on imaging influenced the final pathological diagnosis as often appears to be the case with this rare tumor. We briefly discuss paranasal sinus osteosarcomas.