Recently we experienced a case of rhinolith heavier than any previously reported case in the left nasal cavity with septal perforation. A 48-year-old male patient was first seen on September 4th 1978, suffering from nasal obstruction on both sides with a malodorous purulent discharge. The patient stated that his symptoms had begun years ago, since that time he had complained of purulent nasal discharge and nasal obstruction predominantly on left side. But he had complained of both sides nasal obstruction and bloody discharge since 3 years ago. Anterior rhinoscopy revealed a yellowish hard object occupying both nasal cavities and purulent discharge on both nasal cavities. Under the general anesthesia, the mass was removed with lateral rhinotomy and lip splitting and partial removal of pyriform aperture, and this measured 8cm by 4.5cm by 4cm and weighed 123.5gm. The patient was able to breath without a sense of obstruction, malodorous discharge and recovered with good condition.