Abstract: Adenoid cystic carcinoma (ACC) is one of the commonest malignant salivary gland tumors, affecting minor salivary glands and rare in the nose and paranasal sinuses. ACC in maxillary sinus usually mimic inflammatory disease and has a poor prognosis. A case report of 37 yr old male with ACC of left nasal cavity who presented with mass in left nasal cavity and swelling in left cheek is presented here. The CT scan showed mass in left nasal cavity and over frontal process of maxilla with bone resorption. Surgical excision was done by Lateral Rhinotomy approach and biopsy revealed ACC. Post op radiotherapy given and regular follow up done. The sinonasal ACC has an overall poor prognosis due to perineural invasion and post-operative radiotherapy is important to address the microscopic disease.