Benign fibro-osseous lesions (BFOLs) of the maxillofacial bones represent a diverse group of pathologic conditions that includes developmental lesions, reactive or dysplastic diseases, and neoplasms. Owing to substantial overlap of the histopathologic findings, subclassification of BFOLs may be problematic. Moreover, this is not merely an academic exercise because the therapeutic management of BFOLs varies depending on the actual disease process. To further complicate matters, a number of other disease processes demonstrate clinical, radiographic, and microscopic features that bear resemblance to those encountered in recognized fibro-osseous conditions. The objective of this article is to review the most current clinicopathologic, radiographic, and molecular studies of BFOLs to aid the surgical pathologist in the recognition and diagnosis of this diverse group of maxillofacial lesions. A discussion of the various disease processes that occasionally may be confused with BFOLs also is included.