Epithelium-lined cysts of the jaw can be either odontogenic or non-odontogenic. Cysts that exhibit keratinization of their epithelial lining are called odontogenic keratocysts. They compose approximately 8% of all odontogenic cysts. There is a frequent association with unerrupted teeth, and a high incidence of occurrence of keratocysts in the multiple basal cell nevus syndrome. The significance of odontogenic keratocysts is their high potential for recurrence after their removal. There is no specific radiographic feature, however, that distinguishes them from non-keratinized odontogenic cysts. High resolution computed tomography (CT) studies can exquisitely determine the extent of these lesions and pinpoint areas of cortical breakthrough as well as involvement of the teeth. This information is invaluable in surgical planning for excision of these lesions.