OBJECTIVE: To report an unusual presentation of actinomycosis causing intra tonsillary cyst drainage for spontaneous intermittent oral cavity. CASE REPORT: Patient 39 years, white, physician, without co morbidities and with good oral hygiene, he developed spontaneous drainage oral intermittent fetid yellowish liquid for two months. Not reported sore throat or fever, but oral discomfort when swallowing the left. Reported no history of oral trauma or recent dental work. Physical examination showed mild tonsillary asymmetry, with left greater than right without visible lesions. On palpation there was a slight stiffness oral central left tonsil without cervical lymphadenopathy. CT neck with contrast ultrasound and rigid laryngoscopy was normal. He underwent tonsillectomy with a diagnosis of actinomycosis cyst with central necrosis in the left tonsil pathology. CONCLUSION: Actinomycosis sp is a saprophyte of the oral cavity and gastrointestinal tract and rarely causes infections or symptoms. When the cause is usually a symptom of chronic suppurative granulomatosis infection. The cause is usually due to trauma or impaired immunity. This case report is rare in literature, mainly because there is no causal factor of injury or medical co morbidities associated with an atypical presentation of oral actinomycosis.