Background: Ossifying fibroma (OF) in craniofacial is a rare disease, benign, locally aggressive fibro-osseous tumor. In the recent 2017 WHO classifications, OF was divided into two types, ossifying fibroma of odontogenic origin and juvenile ossifying fibroma (JOF). Determining the right surgical treatment to reduce the postoperative recurrence rate is incredibly challenging. Case description: The author reports two cases of OF in paranasal sinuses with disease onset progressed from prepubertal age. The first case is an example of a recurrent case after undergoing conservative surgery and the second case is a new case. All cases underwent radical surgery with subtotal maxillectomy and reconstructive surgery in one stage. After observing all patients until one year, there were no signs of recurrence through clinical and endoscopic examination. Discussion: There are 2 types of surgery that are compared in this case report, conservative surgery procedure, and radical surgery. Conservative surgical procedures include curettage, enucleation, or peripheral osteotomies. Several studies showed high recurrence levels when curettage or enucleation is conducted in OF patients, residue caused by incomplete excision is most the common reason that is easily caused by conservative surgery. Radical surgery such as open maxillectomy shows as a promising approach for degrading the level of recurrence. Conclusion: Juvenile ossifying fibroma, especially trabecular juvenile ossifying fibroma (TrJOF), show a high recurrence percentage compared to other type. The first-choice management for treating OF was the surgical approach. Types of surgery choose to depend on the aggressiveness and morbidity of the disease. Radical surgery was proven better to decrease the level of recurrence compared with conservative surgery.