Delanian et al. reported the efficacy of pentoxifylline-tocopherol-clodronate (PENTOCLO) treatment for osteoradionecrosis (ORN) of the mandible in 2011. Spontaneous sequestration and epithelialization of the mandibular lesion are induced by this method. We report a case of osteoradionecrosis of the mandible which responded to treatment with PENTOCLO. A 60-year-old man was referred to our department with persistent mandibular ORN after definitive chemoradiotherapy for oropharyngeal carcinoma (T2N0M0). Periodontitis of the right second molar caused ORN, followed by pathological fracture. PENTOCLO treatment was started following 4-week antibiotic therapy. The sequestrum spontaneously separated with mucosal epithelialization two months after the treatment started. The second molar was removed at 11 months because of its increasing mobility. The extraction socket had epithelized and computed tomography (CT) showed that the pathological fracture had healed. No adverse events occurred during this treatment course. PENTOCLO may be an organpreserving treatment option for ORN of the mandible.