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Peripheral odontogenic keratocysts (POKCs) are rare dental cysts that develop in soft tissues like the buccal mucosa. In this video, we explore the clinical manifestations, diagnosis, and treatment strategies based on two real patient cases and a comprehensive literature review. Discover how POKCs differ from common odontogenic keratocysts (OKCs), their high recurrence rates (up to 50%), and why complete excision under surgical microscope is crucial for preventing relapse. Learn about symptoms such as buccal swelling, pain, and limited mouth opening, imaging techniques like CT and MRI, and the role of adhesions in soft tissue complications. We break down the two cases: a 38-year-old female with recurrence after decompression and a male patient post-cyst drainage, both successfully treated with microscopic excision. Plus, insights from 51 reviewed cases, including links to Gorlin-Goltz syndrome and recommendations for long-term follow-up over 3 years. Ideal for dental professionals, students, and patients seeking info on odontogenic cysts. Stay tuned for tips on reducing recurrence risks and advancing oral pathology knowledge.