OBJECTIVE: To describe a sphenoid case of mucopiocele as diagnosis differential chronic headache. CASE REPORT: Patient JLC, masculine sex, 61 years with history of overwhelming chronic headache, difficult specification (not-frontal, not-weather, not-occipital), pain located in backward-orbital position predominantly. Evolution about 6 months. Without other symptoms. Consultations with physician and neurologist had not detected etiology. Symptoms partially improved with use of AINEs or analgesics. About two months before to be consulted in our service, appeared dyplopia - the neurologist, then, requested examination of magnetic resonance. Examination discrete evidenced expansive mass in sphenoid sinus with heterogeneous signal increased in T1 and hypointense in T2, without impregnation for the gadolinium, with protrusion in left nasal tanks and compression of optic nerve in the orbital apex. Suggesting mucoceles of sphenoid sinus. Led to the center surgical and carried through draining. Patient in postoperative accompaniment with symptomatic improvement until the moment.