Nasal dermoid sinus cysts are uncommon congenital anomalies that require interventions only when they present as complications. They frequently present in childhood as midline nasal masses requiring excision. They may present with intracranial as well as intraorbital extensions, making it necessary to subject the patient for proper radiological diagnosis preoperatively. Here, we present a rare case report of 28-yearold male patient who presented at our tertiary health care center with nasal dermoid cyst expanding into the frontal sinus causing proptosis and blurring of vision. The cyst was excised by combined approach, i.e. external nasal dermoid sinus tract excision and endoscopic nasofrontal sinusotomy for complete removal. The embryology, clinical history, diagnosis and surgical management are discussed.