A case of sphenoid sinusitis due to Pseudallescheria boydii is described in a 52-year-old non-immunocompromised woman. Treatment should always involve surgical drainage, and antifungal chemotherapy may be of benefit if there is histological evidence of invasion of surrounding tissue. For P. boydii infection miconazole should be the agent of choice, rather than amphotericin B. For this reason it is important to obtain culture and histological examination of sinus contents if fungal infection is suspected.