Midline dermoid cysts, although rare, typically present as nasal or glabellar masses with potential sinus tract extension to the skin or to the central nervous system. Craniofacial dermoid cysts present in varied ways, including asymptomatic puncti, infection, or seizure secondary to intracranial invasion. This article describes the previously unreported occurrence of a midline dermoid within the labial frenulum diagnosed on surgical excision of the cyst and its orocutaneous sinus tract, which extended to the skin at the base of the columella.