The odontogenic keratocyst (OKC) is an epithelial developmental cyst of the jaws; its main source of origin in the dental lamina or its remnants, the OKC is a distinct entity from the odontogenic cysts that deserves special attention due to its aggressive clinical behavior and high rate of recurrence. The World Health Organization Working Group and International Association of Oral Pathologists meeting to classify the OKC as a benign tumor with odontogenic epithelium and mature, high recurrence rate pathologic classification, diagnosis, and biologic behavior. There are proponents of “conservative” or “aggressive” methods of treatment. 1) Consider conservative therapies to include enucleation, curettage, and marsupialization. 2) Aggressive treatment as “that which is used in addition to enucleation, and includes curettage (mechanical, physical, and/or chemical) and/or resection with or without loss of jaw continuity. After treatment, the patients require long-term follow up for recurrence of the OKC and also for the subsequent development of the signs and symptoms.