We report a case of a 54-year-old man with an angioleiomyoma originating from the right nasal floor. Nasal vascular leiomyomas are extremely rare tumours. A review of the literature revealed a limited number of cases of vascular leiomyoma in the nasal cavity. Clinically, they are characterised by nasal obstruction, epistaxis or pain as the primary symptom. Up to our knowledge, this is the first case in which a 3D CT scan was performed preoperatively. 3D CT scan reconstructions can show the delineation of the tumour very accurately helping to establish the therapeutic plan for removal. The definite diagnosis can only be confirmed by histopathology. Histopathologically, a vascular leiomyoma demonstrates proliferation of smooth muscle cells intermingled with dilated venous vessels.