Patient: Male, 32-year-old Final Diagnosis: Foreign body in maxillary sinus Symptoms: Blindness • eye bleeding • eye pain • history of trauma Medication: — Clinical Procedure: Caldwell-Luc Specialty: Otolaryngology Objective: Unusual clinical course Background: Paranasal sinus foreign bodies are rarely encountered in otolaryngology practice. Case Report: We present the case of a 32-year-old man who presented to our Emergency Department with his left eye bleeding after a nail gun injury. The initial physical examination revealed the presence of a left eye ruptured globe, which led to left eye blindness. An urgent plain X-ray scan was done, in which the presence of a metallic object impacted in the left maxillary sinus was demonstrated. The patient was managed surgically by an external approach using the Caldwell-Luc procedure, with no intra- or postoperative complications. Conclusions: Paranasal sinus foreign bodies, if improperly treated, can cause serious morbidity. Surgical removal, either endoscopically or through an external approach, is required.