Florid cemento-osseous dysplasia (FCOD) is a benign, fibro-osseous lesion of the jaws characterized by replacement of normal bone with fibrous tissue and cementum-like calcifications. It most commonly affects middle-aged women and appears bilaterally or in multiple quadrants on radiographs. Although usually asymptomatic, FCOD poses significant challenges for dental surgery. The sclerotic, avascular nature of the affected bone predisposes patients to delayed healing, secondary infection, and osteomyelitis after invasive procedures. Because elective surgical procedures are relatively contraindicated in FCOD, extractions must be approached cautiously. Atraumatic techniques, limited flap reflection, and infection-prevention measures are critical to reduce postoperative complications.