Unicystic ameloblastomas are considered to be a less aggressive form of ameloblastoma and treatment by simple enucleation has been suggested as adequate for the majority of these cases. However, a case of unicystic ameloblastoma is reported which was treated by enucleation and the patient presented 21 years later with a multicystic recurrence. This raises the question of whether the unicystic variety should be treated in the same manner as the multicystic and solid varieties, thus necessitating a common approach to treatment and post-operative follow-up of all forms of ameloblastoma.