Objectives: To present a case of a inflammatory myofibroblastic neoplasm, sinonasal in origin, discuss its clinical features, and discuss diagnostic challenges encountered and management modalities done for the patient’s case; review the current literature in diagnosis and treatment for inflammatory myofibroblastic neoplasm Case Report: A 37 year old male consulted for left facial swelling with a background of 3 month history of recurrent epistaxis. Office-based endoscopy and biopsy showed a fleshy mass that was friable and had brisk bleeding upon biopsy. Office-based biopsy showed chronic rhinosinusitis only. CT and MR imaging done had differential diagnoses including inverting papilloma, nasal angiofibroma, and inflammatory pseudotumor. A second endoscopic-guided biopsy under general anesthesia was done, with an initial diagnosis of spindle cell lesion. Open and endoscopic antero-medial maxillectomy was done and final histopathology showed inflammatory myofibroblastic neoplasm, ALK-negative. Conclusion: Inflammatory myofibroblastic neoplasm of the sinonasal region is a rare soft tissue tumor that remains to be studied in its behavior, diagnosis, and prognosis.