Nasal septal abscess is a rare entity (1, 2) and is truly a rhinology emergency. The most common aetiology is usually trauma-related. In even rarer circumstances, no cause may be identified from the history or investigations and so may be termed idiopathic. This case is presented to highlight such an idiopathic case and to accentuate the importance of having a high clinical suspicion for patients presenting with nasal obstruction and features of toxaemia. Prompt diagnosis and immediate therapy is mandatory to avoid not only cosmetic nasal deformity but also life-threatening intracranial infections.