Nasal septal abscess is an uncommon condition, yet presents as a rhinological emergency. Its symptoms resemble upper respiratory tract infection and the diagnosis may be missed leading to intracranial complication and cosmetic deformity. We present a healthy patient with idiopathic nasal septal abscess who complained of acute complete nasal obstruction, fever and nasal pain. Common aetiologies, causative agents, complications and management of nasal septal abscess are discussed.