Following sharp excision of oral pathology, management of the residual defect is often a quandary. The oral mucosa can often be extensively undermined; however, in some instances, primary closure with local advancement is not desirable because of the potential to distort adjacent anatomy. In such circumstances, alternative treatment options include healing via secondary or tertiary intention. In this article, we present a 79 year-old female who underwent sharp excision of an epulis fissuratum from the left maxillary labial mucosa resulting in a 3.5 cm oral defect. Using a Z-plasty transposition flap, closure was achieved without distortion of adjacent anatomy.