Medulloblastoma is the most common malignant brain tumor of childhood, with a propensity for neuraxial spread via the cerebrospinal fluid. However, systemic metastases can occur in a small minority of patients. Very rarely such metastases can involve the mandible and present with intra-oral swelling. One such occurrence in a patient with medulloblastoma in the setting of disseminated disease is reported with a review of the relevant literature. The treatment options for patients with extra-neuraxial metastases are limited and their prognosis continues to remain poor.