Background & Objectives: Fibro-Osseous-Lesions (FOLs) in jaws have been considered as one of the most important diagnostic challenges. FOLs are benign lesions in which part of the normal jaws bone is replaced by mineralizing fibrotic connective tissue. Different types of FOLs have some differences in etiology, treatment and prognosis but they may show similar in radiographic and microscopic view. Furthermore, they may also have microscopic similarities with some low-grade malignant lesions of the jaw. Therefore, in this review, we have tried to bring this always challenging story to a good and practical conclusion by providing specific and practical indicators for more accurate diagnosis of these lesions by examining the most important related studies.

  Materials & Methods: Evaluated studies were in the range of 2011 to 2021. Our criteria for entering the study were associated researches with diagnostic challenges of FOLs and purposes of the study include: determining the connection among the clinical and pathologic FOLs, distinguishing various diagnostic challenges of FOLs from each other and malignant bone lesions. 

  Conclusion: The results of this study declare that accurate and correct diagnosis of FOLs requires a connection between clinical, radiographic and histopathological data.