Background: Juvenile angiofibroma (JA) is a rare fibrovascular tumor affecting young males. Although histologically benign, JA is clinically aggressive, with high morbidity, mortality, and recurrence rates. While β-catenin expression is known to contribute to JA growth, its role in recurrence remains uncertain. Objective: This study investigates the relationship between β-catenin expression and recurrence risk in JA patients. Method: An analytical observational case-control study was conducted at Dr. Cipto Mangunkusumo Hospital, analyzing 33 JA patients who underwent tumor excision (2013–2022). Patients without recurrence were controls, while those with recurrence were cases. Immunohistochemistry and H-scoring quantified β-catenin expression, and statistical analysis examined its association with recurrence. ROC curves determined cut-off values. Results: Among 33 patients (all male, aged 9–28 years; mean: 16.2 years), 15 had recurrences. High β-catenin expression was significantly associated with recurrence (p = 0.000), with an H-score cut-off of 124.2 (100% sensitivity/specificity). Age ≤18 years correlated with higher recurrence risk (p <.05; OR 8.9). Tumor size, volume, stage, pre-extirpation procedures, surgical techniques, and intraoperative blood loss had no significant effect. Conclusion: High β-catenin expression is a strong predictor of JA recurrence, suggesting its potential as a prognostic marker. Targeting β-catenin pathways may aid in recurrence prevention and improved JA management. © 2025 Acta Oto-Laryngologica AB (Ltd).