Aim: To study the importance of early recognition of oral cancer in children and its most suitable management. Background: Head and neck cancers are the sixth most common cancer worldwide with rare incidence in children. It is associated with a poor prognosis. Case description: A 10-year-old healthy girl with good oral hygiene presented with complaints of lesion in right mandible for 3 months duration. Incision biopsy of lesion showed squamous cell carcinoma. Computerized tomography showed cortical erosion of mandible, with no significant neck nodes. Case was discussed in multidisciplinary team and options were weighed. After discussing with patients' relatives, it was decided to proceed for surgery. Conclusion: Surgery was undertaken, patient underwent wide excision of lesion with segmental mandibulectomy, neck dissection and free fibular reconstruction of the defect. She is on regular follow-up for the past one year, with no evidence of lesion. Clinical Significance: Squamous cell carcinoma of mandible in children is very rare. Treating physician should be aware of such unusual presentation of highly mortal disease. Literature review on treatment being sparse and surgery followed optimal reconstruction is a major challenge.