Nasal cavity hemangioma is a relatively rare benign tumor; barely 2-3% of all benign neoplasms are nasal hemangiomas. This study demonstrated that the most common clinical presentations of nasal hemangioma are epistaxis and nasal obstruction. However, the correct diagnosis cannot always be evident, as nasal septum hemangioma can appear with unusual symptoms such as septal perforation and recurrence of disease. Atypical manifestation can simulate other diseases. Although nasal septum hemangioma is usually manifested with common symptoms, it is always necessary to perform a diligent clinical examination. This occurrence with unusual clinical manifestations of the nasal septum hemangioma was reported in two cases. In the first case described here, a 63- year-old female having a septal hemangioma and a septal perforation, with a history of a breast cancer. The second case was a 27-year-old female presented with a septal hemangioma and a septal perforation, as well. Both patients had no previous operations in the nasal cavity. We discuss incidence, localization and etiology features of this pathology.