Osteomas are benign tumors that consist mainly of mature compact or cancellous bone. The most common site in maxillofacial complex is the mandible, particularly the angle, followed by sinuses. The authors report a case of an ivory osteoma of the paranasal sinus in a 16 year-old male patient. The lesion was located in the left paranasal sinus (frontal, ethmoidal and maxillary), obstructing the nasolacrimal duct, resulting in dacryocystitis and frontal mucocele. The ethmoid and orbital portions were approached and excised through a Weber-Ferguson incision and maxillary osteotomy was carried out to remove the ivory osteoma, considering its location in the central and deep region of the face. After tumor removal and drainage of frontal and ethmoidal sinuses, the bone flap was repositioned using titanium microplates and screws. Soft tissue was then sutured. The patient was seen again at 3 weeks, 3 months and 2 years after surgery. Overall, he showed a good recovery and wound healing. A multispeciality team approach is advisable in such cases if radical excision is necessary. A craniofacial approach made radical single stage excision of this multicompartmental ivory osteoma possible with an uneventful postoperative period.