Salivary gland carcinomas are rare and clinically diverse group of neoplasm among which mucoepidermoid carcinoma comprises approximately 10-15% of all salivary gland neoplasm. These malignancies are diagnosed generally at a later date during the course of the disease as they are mostly asymptomatic in nature and become symptomatic in the later stages of the disease process. We report a case of high grade mucoepidermoid carcinoma of the maxillary sinus in a 78 year old male patient in which the tumour perforated the skin on the medial aspect of the infraorbital region before the patient underwent surgery.