A 1-day-old female African newborn weighing 3500 g was referred for management of a large oral mass that protruded from the mouth and caused maxillary protrusion and flattening of the nose. The patient was having difficulty breathing. She was born by spontaneous vaginal delivery to a mother who was unaware of the date of her last menstrual period. She had no prenatal medical care, so there was no opportunity for prenatal diagnosis. Initial examination revealed a mass that occupied the majority of the oral cavity and protruded from the mouth. On palpation, the mass appeared to arise from one side of the palate, and there was an adjacent palpable cleft. No other congenital anomalies were evident on physical examination. The patient had some breathing difficulty, but the airway was patent. She was administered oxygen and intravenous fluids, and a nasogastric feeding tube was successfully placed. Feeding was commenced at 35 ml, eight times per day, and she stabilized. On day 5, she was taken to surgery. Laryngoscopy was performed using a standard Macintosh blade size 1, and an easy intubation with a 2.5 endotracheal tube. The mass was excised under general anesthesia, Good hemostasis was achieved, and complete resection of the tumor was accomplished. There were no immediate postoperative complications. Gross examination revealed a large fibrocystic tumor involving the oral and nasal cavities with its base originating from the hard palate. It measured 6 × 5 × 4.5 cm and was well circumscribed. Histopathologic examination revealed a congenital primarily epidermal teratoma. She had an uneventful postoperative course, although a palatal defect remained. She had no difficulty opening or closing her mouth. Bottle feeding with expressed breast milk was initiated shortly after surgery and was well tolerated. She was able to breastfeed by postoperative day 5. On postoperative day 30, the patient was taken back to surgery, where she underwent successful palatoplasty. She was discharged home with her mother on postoperative day 9 after palatoplasty.