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Benign fibro-osseous lesions (BFOLS) of the jaws are a wide array of lesions that actually represent distinct phases of a single benign morphological process. These lesions share certain histopathological features which are in common with giant cell containing lesions, which include central giant cell granulomas (CGCGs). The association of BFOLS and CGCG has to be critically evaluated, pertaining to their clinical, radiologic and histologic features. Many pathologists diagnose these types of lesions, considering only one of the prominent features. Eventually, surgeons end up treating these lesions inadequately. This ambiguity may be because of very small number of cases have been reported in the literature, with uncertain clinical, radiologic and histologic features. We are reporting a case of fibrous dysplasia (FD) which was associated with a central giant cell granuloma (CGCG) and discussing the hypothetical pathogenesis of giant cells.