Gigantocellular lesions are a benign, heterogeneous group of conditions which are characterised by the presence of multinuclear giant cells in fibrous stroma with the most common localisation in the jaw bones. According to the 2022 classification, this group includes central and peripheral gigantocellular lesions, cherubism and simple and aneurysmal bone cysts. All forms have a very similar clinical picture, microscopic as well as radiological findings. Certain entities have their specific characteristics of the time of manifestation, localization and genetic characteristics. The clinical picture varies between asymptomatic lesions which are a random radiological finding and cases with moderate pain, paraesthesia and deformities. Brown tumour in hyperparathyroidism is a skeletal manifestation of metabolic disease diagnosed by laboratory blood and urine tests. According to other parameters, the brown tumour is identical to the central gigantocellular lesion therefore it is necessary to exclude the metabolic causes of the disease by laboratory tests. Pharmacological and non-pharmacological treatments are used in the treatment of giant cell lesions. Conservative surgical therapy includes enucleation, curettage with or without osteotomy and partial resection while the choice of therapy depends on the aggression of the lesion. In recent years there have been efforts to popularise pharmacological treatments suggesting the use of calcitonin, anti-resorptive agents and immunomodulators. In order to better understand pathogenesis, diagnostics and ultimately to select the appropriate therapy for these lesions further research and discussions are needed.