HighlightsIntraosseous venous malformations of the zygoma is rare.Venous malformations are often misrepresented as “hemangiomas”.Preoperative arteriography and embolization are necessary for diagnosis and hemorrhage control during operation.En-bloc resection and primary reconstruction of the lesion is important to prevent recurrence and postoperative malar irregularity.For reconstruction, calvarial bone graft is optimal for maintaining malar contour.