INTRODUCTION: Juvenile nasopharyngeal angiofibroma (JNA) is a rare tumor, that accounts for 0,05%-0,5% of all head and neck tumors. It presents a benign appearance on histology; however, its significant vascular component can bleed and lead to severe epistaxis, and it can invade locally in an aggressive manner with consequents symptoms, including nasal obstruction. JNA is typically a disease of male teenagers. The tumors is originate in thesphenopalatine foramen extend to the nasal cavities and nasopharynx and eventually invade the orbit and cranium. There are many therapeutic options but the most effective is surgical excision. Methods: We monitored a pacient of JNA for 16 years, starting from before surgery and continuing through the intra-operative course, including the period of chemotherapy and radiotherapy. Results: We found a tumor that had the consistency ofsoft tissue andirregular contours and obliterat the nasopharynx and sphenoid sinus with bone lysis extension to the posterior regionof the nasal cavityandtheposterior ethmoid cells, and partial obliteration of the maxillary sinuses. The skull base was unaffected. Surgery was performed by Caldwell-Luc method with expanded endonasal approach. The patient had to be transfused with four units of bloodduring surgery despite having embolized and ligated the external carotid artery. CONCLUSION: Juvenile nasopharyngeal angiofibroma is a tumorthat requiresearly diagnosis to prevent morbidity and complications.