Abstract: Aims: This case report explores sinonasal glomangiopericytoma (GPC) a rare, low-grade mesenchymal sinonasal neoplasm. (1) Methods: Clinical course, imaging, and histopathology of a man in his 60s presenting with recurrent severe epistaxis were reviewed. Initial haemorrhage control required selective arterial embolisation. Subsequent endoscopic evaluation identified a vascular lesion in the left nasal cavity adjacent to the cribriform plate. Representative imaging and histological findings are presented. Results: Nasoendoscopy demonstrated a highly vascular mass arising from the left septum and olfactory cleft region. Contrast-enhanced CT and MRI showed a well-circumscribed, avidly enhancing lesion abutting the cribriform plate without skull-base or orbital invasion. Histopathology confirmed sinonasal GPC, demonstrating perivascular spindle cells with characteristic “staghorn” vessels and immunohistochemical positivity for smooth muscle actin and nuclear β-catenin. The patient underwent complete endoscopic resection and remains under structured surveillance. Conclusion: Refractory unilateral epistaxis should prompt consideration of underlying vascular neoplasms, even in anticoagulated patients. Imaging features of GPC may be subtle and non-specific, making targeted endoscopic assessment and histopathological confirmation essential. Pre-diagnostic embolisation can provide effective haemorrhage control in selected high-risk patients. Given reported recurrence rates of up to 25%, long-term endoscopic follow-up is recommended. (2) References: 1) Asimakopoulos P, Syed MI, Andrews T, Syed S, Williams A. Sinonasal glomangiopericytoma: is anything new?. Ear, Nose & Throat Journal. 2016 Feb;95(2):E1-6. 2) Thompson LD, Miettinen M, Wenig BM. Sinonasal-type hemangiopericytoma: a clinicopathologic and immunophenotypic analysis of 104 cases showing perivascular myoid differentiation. The American journal of surgical pathology. 2003;27(6):737-49.