OBJECTIVE: To report the case of polyps sphenochoanal, diagnostic methods, highlighting their differential diagnoses and treatment. CASE REPORT: TSS, 27 years old, male, white, complained of bilateral nasal obstruction, progressive, worse on the right, started three years ago. Reported hyposmia, anterior rhinorrhea, and headache hemicranial right, pulsatile, applicant, accompanied by dyspnea lasting three days. He denied otological complaints, laryngeal allergy symptoms or epistaxis. Anterior rhinoscopy: deviated septum to the left and inferior turbinate hypertrophy. Laryngoscopy: septal deviation to the left, bottom, grade II, with difficulty in the evaluation of the left middle meatus. Through the left choanae was visualized mass cavum, polypoid, from the contralateral nasal cavity. Right polypoid mass was found obstructing the passage of the fiberscope. TC of the paranasal sinuses, nasal septum deviation to the left and thickening of the mucous lining of the maxillary sinus, ethmoid and sphenoid sinuses consistent with sinusitis. Proposed FESS surgery. The esphenoetmoidal region recess was addressed by identifying the implementation of the polyp in the wall of the right sphenoid sinus, and extending the drainage ostium. Dissection and removal of the polyp implantation. As a result, there was septoplasty. Histologically identifies nasal polyps. Further, no recurrence was found. CONCLUSION: The diagnosis of nasal polyps, it should be pointed surgical treatment, and excision of endoscopicaly polyps a less aggressive and effective method, with therapeutic function, and in some cases the diagnosis.