Melkersson-Rosenthal syndrome (MRS) is a rare idiopathic non-caseating granulomatous condition. It is rarely described in otorhinolaryngology-related journals, although facial palsy, lip-swelling, and lingua plicata, are its most common presenting features. This classical triad however is not always present in MRS. Other forms of orofacial swelling exist. This paper describes a patient with a variant of MRS, treated by us with intra-lesional steroid injection. We also discuss the other differential diagnoses that may mimic MRS.