OBJECTIVE: The authors describe a case nasal myiasis relapse, its treatment, and a literature review. CASE REPORT: J. S., a 68-year-old black man, married farmer, natural, and a resident of the Rural Zone of Santa Ines-MA, sought the service of ENT-HMTM with intense facial pain and nasal bleeding for 10 days. During the medical history, the companion of the patient reported another case of myiasis 18 months before. An inspection revealed a decrease in the nasal dorsum, and anterior rhinoscopy showed bilateral myiasis. He underwent manual removal of the larvae and drug treatment with ivermectin (200 µg/kg in a single dose). He recovered with general improvement and the pain and bleeding disappeared. CONCLUSION: Nasal myiasis is a cavity infestation by larvae of Diptera, Cochliomyia hominivorax being the most common in Brazil, which evolves as the parasites feed on the living or dead tissues of the host. Rare in humans, it is frequent in tropical and rural areas, in people over 50 years of age, in areas of low socioeconomic status, and shows no gender preference. Eggs are deposited directly into the cavity or deposited near the nasal cavity when the patient is sleeping, after being transferred to the nasal cavity because of poor hygienic conditions or by the finger of the patient. Atrophic rhinitis is a risk factor, and ulcers, rhinorrhea, and poor hygiene are attractive factors. Early diagnosis prevents complications, such as orbital, nasal, and paranasal tissue, and even intracranial complications. To prevent incidence and relapse, we advise improvements in hygienic conditions and the reduction of risk and attractive factors.