Abstract To solve the upper airway obstruction can be essential for the respiratory function. Choanal stenosis is rare disease of upper airway. The treatment of choanal stenosis is to do surgical reconstruction approach. And pedicled nasal septal flap is the appropriate option of reconstruction solution. We describe a 26-year-old female with symptom of nasal obstruction of left nasal cavity. There were no previous nasal surgery/trauma and systemic diseases. The endoscopic and computed tomography findings showed left deviated nasal septum and stenosis of left choanae. The surgical approaches (septoturbinoplasty and left choanal stenosis reconstruction with posterior nasal septal flap) were carried out. There were no postoperative complications during outpatient clinic department follow up. Pedicled nasal surgical flaps can be used to reconstruct nasopharyngeal lesion successfully. Keywords: Choanal stenosis; Reconstruction; Flap