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Cancer of the oral cavity and pharynx represents the 7th most diagnosed malignancy in Spain. Mucoepidermoid carcinomas are the most frequent malignancies of the minor salivary glands of oral cavities. The purpose of this report is to describe the very rare case of an alveolar ridge high-grade mucoepidermoid carcinoma presenting as an inside socket radiolucent lesion, simulating an apical cyst. The patient was diagnosed in our unit for oral and maxillofacial surgery and treated with surgery and adjuvant radiotherapy. The patient continues to be free of recurrent/persistent, local/regional disease after two years of follow up. Non-healed tooth related lesions present for more than one year are strongly recommended to be biopsied and evaluated histopathologically.