Introduction: Schwannoma is a benign tumour arises from the Schwann cells. Involvement of sinonasal tract is very rare constituting about 4%. In sinonasal tract ethmoid sinus is most commonly involved followed by the maxillary sinus.

Case description: We report a rare case of ancient schwannoma in a 67-year-old male, arising from the posterior wall of left nasal septum. Histopathology after complete excision of the mass confirmed the diagnosis of ancient schwannoma. IHC for S-100 showed diffuse and strong positivity.

Discussion:  Common symptoms include nasal obstruction, epistaxis, anosmia, and nasal deformity due to expansile nature of the tumour. Microscopic features show hypercellular Antoni A and hypocellular Antoni B areas, and the characteristic feature of the palisading cell arrangement called Verocay bodies. Ancient schwannomas exhibit bizarre cells and extensive hyalinization, which attributes to degenerative changes.

Conclusion: Schwannomas arising from the nasal septum are very rare; however, they should be considered as differential diagnosis in patients presenting with nasal septal masses. These tumours are generally benign and show a very low rate of recurrence after excision. Management involves surgical removal followed by careful follow-up.