Background: We present a case history of a patient with nasal mucocutaneous leishmaniasis, also known as Espundia. Knowledge of this tropical infectious disease is usually limited among otorhinolaryngologists, but is of importance because patients may present with symptoms in nose or mouth. Case presentation: A 25-year old healthy man was referred to our outpatient clinic with nasal obstruction and swelling at the left part of the nose since two weeks. The patient had travelled to Peru several months ago. After extensive diagnostic testing, mucocutaneous leishmaniasis was diagnosed. Leishmaniasis is a tropical infectious disease caused by a parasite of the Leishmania-family. Depending on the species, it can cause cutaneous, mucocutaneous or visceral disease. Mucocutaneous leishmaniasis, called ‘Espundia’, has a preference for the nasal mucosa and can lead to severe tissue destruction in the nasopharyngeal region. This disease should always be treated. Conclusion: This case is presented for two reasons. Firstly, knowledge of this disease is important in reducing doctors’ delay, because mucocutaneous leishmaniasis may lead to secondary infection and facial deformation. Secondly, due to globalisation and climate change an increase in incidence of leishmaniasis in Europe is expected. Therefore, otorhinolaryngologists will more frequently be confronted with leishmaniasis and should be able to recognise it.