The adamantinoma is characterized by a high rate of local recurrence. Because of this peculiarity, radical treatment is generally preferred than conservative surgery. Resection with free margins is associated with lower risk of recurrence but is not recurrence free; thus, the importance of long and scrupulous follow-up is evident. The aim of this study was to present a patient with recurrent mandibular adamantinoma after box resection with safety margins of 1 cm that has necessitated of a segmental resection with 1-step reconstruction with revascularized fibula free flap.