OBJECTIVE: To report a case of sphenoid nasoangiofibroma in a patient treated at the full service Otolaryngology and Facial Cervico-Presidente Prudente / SP in March 2013. Report: A. M. S., a 27-year-old male, brown, from Teodoro Sampaio / SP was treated in the otolaryngology department complaining of nasal obstruction for 1 year, associated with self-limited and intermittent epistaxis for 1 month in moderate amounts, and rhinorrhea and pain in the facial region. Rhinoscopy showed a grade 2 middle septal deviation and normotrophic turbinates. He visited the emergency department with symptoms of self-limited, moderate, recurrent epistaxis, and was hospitalized. Fibronasolaryngoscopy showed a smooth, pedunculated lesion in the posterior tail of the middle turbinate of the right nasal cavity with a bleeding ulcer near the nasal floor measuring approximately 20 × 20 mm, occluding 80% of the right choana. A CT scan of the facial sinuses revealed a nasal septal deviation to the right associated with a mass in the nasal cavity measuring 33 × 18 mm, extending to the posterior nasal cavity and the right sphenoid sinus with homogeneous enhancement after contrast administration. Hematological examinations were within the normal range. The patient opted for endonasal tumor resection, which was performed successfully. Pathology revealed a sphenoid nasoangiofibroma. The patient has followed up as an outpatient without further complaints. CONCLUSION: An angiofibroma is a benign, vascular tumor, but locally invasive and with a high incidence of persistence and recurrence, often occupying the pterygopalatine and sphenopalatine fossa, and less commonly displayed in the sphenoid sinus, which was the structure affected in this case. Complaints of rhinorrhea, nasal obstruction, and epistaxis are common in ambulatory practice, and require a thorough investigation of a differential diagnosis between various nasal tumors.