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Cephalic Tetanus: A Rare Case Report. INTRODUCTION: Tetanus is a preventable infectious disease with vaccination. Cephalic tetanus is the rarest form in which local tetanus can involve the cranial nerves. CASE: Herein, we report a case of cephalic tetanus in a 16-month-old girl who had never been vaccinated. The patient, who had a complaint of a wound on the cheek mucosa for 2 weeks, was seen playing with the soil in the garden 1 week ago and was found to have abundant soil removed by her mother. The patient was diagnosed as cephalic tetanus according to her complaints and clinical findings. DISCUSSION: We believe that, this is the first case reported in the literature of cephalic tetanus in such a young child wherein the disease focus of infection from a wound on the cheek mucosa. The symptom we defined as 'a child who cries when she smiles' presented in this case could only be associated with this disease. CONCLUSION: In addition to detailed anamnesis and meticulous physical examination, the clinical symptoms that we have described for the first time in a child with cephalic tetanus should also be considered for early and accurate diagnosis.