<p>Osteoblastoma is a rare benign osteogenic tumour, accounting for less than 1% of primary bone neoplasms, with infrequent involvement of the maxillofacial region. Maxillary osteoblastoma in paediatric patients is exceptionally uncommon and may present a diagnostic challenge due to its clinical and radiographic resemblance to fibro-osseous lesions such as ossifying fibroma. We report a case of a female child in her first decade presenting with a six-month history of progressive left midfacial swelling and dull pain. Clinical examination revealed a firm expansile lesion involving the left maxilla with intraoral extension. Radiographic evaluation demonstrated a well-defined mixed radiolucent–radiopaque lesion with internal calcifications, cortical expansion, and involvement of the maxillary sinus and nasal cavity. An incisional biopsy suggested a fibro-osseous lesion favoring ossifying fibroma. The lesion was surgically managed by complete enucleation via an intraoral approach. Histopathological examination of the excised specimen confirmed the diagnosis of osteoblastoma. The postoperative course was complicated by a palatal fistula, which was successfully managed with a palatal obturator and subsequently resolved. At 18 months of follow-up, the patient remained asymptomatic with no clinical or radiographic evidence of recurrence, and satisfactory restoration of function and facial symmetry was achieved. This case highlights the diagnostic complexity of maxillary osteoblastoma in paediatric patients and underscores the importance of comprehensive clinicoradiological assessment and definitive histopathological evaluation. Complete surgical excision remains the treatment of choice, and long-term follow-up is essential to monitor for recurrence.</p>