Osseous dysplasia (Cemento-osseous dysplasias) is relatively common form of fibro osseous lesions (FOLs) in the tooth-bearing regions of the jaw bones. Clinically, most of the Osseous dysplasias (ODs) are asymptomatic and are accidently discovered during routine radiographic examinations. A proper diagnosis of OD is very crucial to avoid misdiagnosis and mismanagement. The histological appearance is similar to other fibro osseous lesions (FOLs) and in numerous cases; Osseous dysplasias have been misdiagnosed as periapical lesions (Periapical abscess, granuloma or cyst), and/or mismanaged by initiation of unnecessary endodontic and surgical interventions. We report a misdiagnosed case of Focal Cemento-Osseous Dysplasia and unnecessary endodontic treatment in a 48 years old woman due to similar radiographic appearance of the lesions during the osteolytic phase of Osseous Dysplasia. This unnecessary invasive treatment could have been minimized or avoided if standard protocols of pulp vitality and a radiographic interpretation were performed carefully.