INTRODUCTION AND IMPORTANCE: Nasal septal abscess (NSA) is a rare complication of acute sinusitis in children. It is very difficult to find in the literature. NSA can have devastating complications. These include potentially life-threatening intracranial infection and cosmetic deformity of the nose. These complications, which affect not only functional but also vital prognosis, can be prevented by early diagnosis and treatment. CASE PRESENTATION: We report the case of a 13-year-old boy who presented to the emergency department with a 2-day history of bilateral eyelid oedema extending to the nasal ridge, associated with bilateral rhinorrhea and nasal obstruction. Clinical examination revealed bilateral red septal swelling. A Computed Tomography (CT) scan of the nose and paranasal sinuses showed pansinusitis with nasal septal abscess. Treatment consisted of evacuation of the abscess combined with dual antibiotic therapy. The course was favorable. CLINICAL DISCUSSION: NSA is relatively rare, with most reported cases secondary to trauma-related nasal septal hematoma. Serious complications can result from delayed management of NSA. To avoid these unnecessary complications, the diagnosis should be accurate and treatment should be prompt. CONCLUSION: NSA is a serious condition that requires urgent surgical management to prevent potentially life-threatening complications.