Ossifying fibroma is a fibro-osseous tumor that tends to be well-defined, has a propensity for the mandible, and has a high potential for recurrence. Psammomatoid ossifying fibroma is an aggressive variant of juvenile ossifying fibroma and can destroy surrounding structures. This case describes the unusual presentation of psammomatoid ossifying fibroma of the mandible. A 30-year-old female patient presented with a history of progressive swelling on the right side of her face from the past 10 years, causing facial contour deformity. It details the diagnostic process, treatment challenges, and potential implications of a massive psammomatoid ossifying fibroma affecting the mandibular ramus. The clinical, radiological, and histological findings about management plans and outcomes are discussed and pertinent literature has been reviewed. The impact of the multidisciplinary approach on treatment outcomes and patient quality of life will also be taken into account. The worth of immediate reconstruction with free flaps and a 3D stereolithographic model is also discussed.