Acinic cell carcinoma is a tumor that occurs most commonly in the parotid glands. We have experienced a rare case of acinic cell carcinoma of the left maxillary sinus. The patient was a 71-year-old female. She noticed her left nasal congestion and epiphora from left eye in April 1994. She had a history of left maxillary sinus surgery in February, 1972. Antrotomy was performed and histopathological examination of specimen from the maxillary sinus proved acinic cell carcinoma. The tumor was considered to be the recurrence 22 years after initial surgery, because it coincided with the surgical specimen of previous surgery. Radical resection of maxilla was performed for complete resection of tumor with palate reconstruction by left scapula and latissimus dorsi myocutaneous flap. No recurrence is observed for more than 4 years after surgery. Although this tumor is of low grade malignancy, complete resection with adequate surgical margin is advisable due to high incidence of this tumor to recur after long periods of time.