This report presents a living 94-year-old female with known metastatic pulmonary ameloblastoma diagnosed over 37 years ago. Initial treatment for the primary lesion of the anterior mandible was carried out 18 years before diagnosis of pulmonary lesions. Despite the presence of bilateral pulmonary metastases, the patient remains asymptomatic and received no treatment for these lesions. To our knowledge this case represents the longest survival time recorded after appearance of untreated metastatic disease.