A female patient presented with facial pain, discharge and headache. She had undergone excision of a palatal swelling 2 weeks previously, following which she had developed an oroantral fistula with necrosis of the palate. Imaging studies were suggestive of chronic sinusitis. A biopsy from the maxillary antrum revealed phaeohyphomycosis, a group of fungal infections caused by saprophytic fungi. The patient was treated with antifungal treatment and had a complete response. Phaeohyphomycosis is of rare occurrence in the paranasal sinus and in patients who are immunocompetant. There are only eight previous reports of this occurrence in the literature worldwide.