A 78-year-old Chinese male presented with a 4-year history of a recurrently infected left nasolabial cyst (~3 episodes/year) and 2-month history of purulent oral secretions. Examination showed a 4x3 cm tender left nasolabial swelling and a pus-discharging fistula in his upper left gingivo-labial sulcus. Nasoendoscopy was normal. CT imaging revealed a 4.1x3.7x3.6 cm left maxillary alveolus cystic lesion crossing the midline, without a solid component. FNAC showed inflamed cyst contents, and cultures revealed no bacterial growth. He underwent an endoscopic marsupialization in September 2024, where the cyst was drained and a inferiorly-based mucosal flap was raised. Follow- up scopes revealed no recurrent fistulae, and a widely open cyst cavity. Nasolabial cysts are rare, benign mucus-secreting lesions. While sublabial excision is conventional, endoscopic marsupialization offers fewer complications, shorter surgical time, and lower recurrence risk. It also reduces the risk of nasal mucosal breach which could potentially result in an oro-antral fistula. A sufficiently large intranasal opening (>10x10 mm) is critical to prevent stenosis and ensure long-term success.