OBJECTIVE: To describe a case of rhinolithiasis, the symptoms and the treatment adopted. CASE REPORT: MMP, 30 years old, female, presented headache, nasal obstruction in the left nasal cavity, purulent rhinorrhea, and dyspnea for seven years. Patient reported several previous treatments for sinusitis without success, and has started treatment for migraine with neurologist. In childhood, refers episode nasal foreign body removed by a doctor in the emergency room. Anterior rhinoscopy showed purulent rhinorrhea and viewing gray mass on the left. Nasal endoscopy beyond that rhinorrhea showed amorphous mass, and hardened in the topography of the left inferior meatus. Computed tomography of the paranasal sinuses revealed the presence of solid image density in the posterior third of the left nasal cavity. Based on these results the diagnosis was rhinolith and underwent endoscopic excision and then confirmed by pathology. CONCLUSION: Rhinolithiasis is a rare condition that can have various presentations. A high index of suspicion is necessary for diagnosis, but also the use of radiological examinations. It should always be suspected in cases of nasal obstruction longtime stench, rhinorrhea and unilateral mucopurulent chronic headache. The choice of treatment is surgical removal.