Schwannoma can arise from any cranial, peripheral or autonomic nerve, except the olfactory and optic. About 25-45% of extracranial schwannomas lie in the head and neck. Data on malignant schwannoma from low-income settings are inconsistent. We reported a case of giant periorbital malignant schwannoma successfully treated in a low-income setting. The strength of our case is given not only by the rarity and the size of the disease but also for highlighting the weakness of health system in low-resource settings. It is mandatory to strengthen the health system with particular attention to physical, psychologic and social aspects and to promote comprehensive programs including all these aspects.