Parapharyngeal space tumour is rare in paediatrics. It can either be a primary tumour arising from parapharyngeal space structures, an extension from the surrounding structures or a metastatic tumour. In adults, salivary gland tumours and paragangliomas are common, while neurogenic tumours predominate in paediatrics. The delicate anatomy in the parapharyngeal space makes the diagnostic procedures more complex, especially in paediatrics. Although tissue biopsy can be obtained under sedation or local anaesthesia, it is histologically difficult to differentiate lipoma from liposarcoma. We present a paediatric case with a large parapharyngeal space mass in a 4-year-old boy and the management used.