Osteomas are rare, benign osteogenic neoplasms arising from the bone surface or medullary bone. They are most commonly encountered on the craniofacial skeleton. Complaints including pain and facial asymmetry are managed by surgical excision. The present study presents a case of mandibular osteoma in close relation to the mental nerve and discusses the use of ultrasonography guidance during excision surgery. USG guidance may be used intraoperatively as a cost-effective technique during surgeries of osteomas with close relations to vital structures.