An 80-year-old male presented with painless blurred vision from the right eye following endoscopic biopsy of a right maxillary sinus mass with the otolaryngology service. The patient admitted to progressive right-sided proptosis over the past few weeks. Past medical history was significant for acinic cell adenocarcinoma of buccal space origin with resection 3 years prior. Orbital CT revealed a large, poorly circumscribed destructive mass in the right masticator space with extension to the paranasal sinuses, inferior and medial orbit, and middle cranial fossa. Histopathology confirmed the mass to represent a recurrent acinic cell carcinoma. The patient was treated with chemotherapy, and at last follow-up 2 years after presentation had stable painless globe dystopia and visual acuity. The authors describe a very rare case of a recurrent minor salivary gland acinic cell carcinoma with secondary orbital extension.