Introduction: Although rare, angioleiomyoma is an important differential to consider in nasal masses particularly in comparison to pyogenic granuloma. Most angioleiomyoma’s present with epistaxis and thus it is important to be mindful when considering biopsy in clinic to avoid bleeding.1 We present a case of nasal angioleiomyoma and review its incidence, aetiology and clinical relevance. Case Report: A 41-year-old female presented to ENT Outpatient Department with nasal obstruction and a 1.5cm anterior right nasal septal lesion seen on CT, suspected to be a pyogenic granuloma. We conducted an excision of this nasal lesion in theatre without complication. Histopathology showed an angioleiomyoma. Literature Review: This is a rare differential diagnosis of a nasal mass with only 30 documented cases in English literature. Intra-nasal location comprises just 1% of all angioleiomyomas.2 It is important to refrain from biopsying these lesions in clinic especially if they are occupying a more posterior aspect of the nasal space as bleeding may be hard to control. Treatment is usually complete excision of the lesions and recurrence is extremely rare post this.1 References: 1. Arruda MM, Monteiro DY, Fernandes AM, Menegatti V, Thomazzi E, Hubner RA, Lima LG. Angioleiomyoma of the nasal cavity. Int Arch Otorhinolaryngol. 2014 Oct;18(4):409-11. doi: 10.1055/s-0033-1364173. Epub 2014 Jan 21. PMID: 25992133; PMCID: PMC4297014. 2. Singh R, Hazarika P, Balakrishnan R, Gangwar N, Pujary P. Leiomyoma of the nasal septum. Indian J Cancer. 2008;45(4):173–175.