Epulis is a benign tumor, rarely involves aggressive alveolar bone resorption. This study reported a rare case of rapid growth of pregnancy epulis with extensive alveolar bone destruction and the management of this case. A 24-year old pregnant woman at 35 weeks and 1 day of gestation presented a large asymptomatic nodular mass with severe teeth loosening at the anterior mandibular region for 4 weeks. Radiographic examination showed extensive alveolar bone resorption around the affected teeth to the apical area. After delivery, the patient received an extended resection under general anesthesia. The final histopathological analysis revealed the diagnosis of epulis. In conclusion, the rapid growth of epulis during pregnancy mimicking malignant neoplasm with aggressive alveolar bone destruction was rare and puzzling. In such cases, the histopathological and immunohistochemical examinations are the only effective method to reach the correct diagnosis and clinician should proceed with high precaution.