Dermoid cysts of the nose may present difficult management problems if inadequately evaluated preoperatively or if incompletely excised. It is most important to differentiate them from nasal gliomas, neurofibromas, encephalocoeles, or meningiocoeles. Confusion with other benign lesions such as sebaceous cysts, mucocoeles, inclusion cysts, hemangiomas, or lipomas is possible but of less consequence. Incompletely excised cysts recur and the final result is usually less acceptable than that following total excision. The use of an operating microscope and microsurgical instruments is strongly advocated.