A one-month old baby was referred to the neurosurgical unit, Kenyatta National Hospital, Nairobi, Kenya, with history of being born with a bony outgrowth from the right side of her face which resembled an undeveloped twin. A computerised tomography scan of the brain and the extracranial mass confirmed a defect in the anterior cranial fossa and extension of the mass intracranially. Total surgical excision of the mass was done and facial reconstruction achieved. Histology of the excised mass confirmed a mature (benign) teratoma. Except for location, fronto-ethmoidal teratoma resembles its counterpart in the sacro-coccygeal area. It may arise over the nasion, or within the nose, orbit, or mouth and frequently extends intracranially. Like other teratomatous tumours, malignant changes tend to occur with increasing age. Calcification within the mass is often evident on plain skull x-rays. Treatment consists of early total excision.