This patient developed high-grade mucoepidermoid carcinoma in the maxillary sinus and had to undergo total maxillectomy with orbital exenteration. Sinonasal tract and nasopharynx are extremely uncommon locations for mucoepidermoid carcinoma. Almost 50% of cases of mucoepidermoid carcinoma involve the major salivary glands, predominantly the parotid gland. Submandibular and sublingual glands are less commonly involved. Slightly less than 50% of cases involve the intraoral minor salivary glands located in the palate, buccal mucosa, lips, and tongue.