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Angiolympoid hyperplasia with cosinophilia is a rare benign condition that causes swellings in the head and neck. It is difficult to diagnose prior to biopsy and is frequently mistaken for a malignant tumoour. A case involving a 21-year-old man who presented with a 2 cm diameter fiborous lesion the subcutaneous tissue of the cheek is reported. The clinical and histological features are reviewed and the differences between this condition and the similar condition of Kimura's disease are discussed. Initial treatment with intralesional or sustemic steroids is suggested as this may avoid the need for excision.