Background: Synovial sarcoma of paranasal sinuses (PNSs) is very rare. It is a high-grade malignant tumor of soft tissues. It arises from mesenchymal cells and not from the synovial membrane. The head and neck is the second most common site for synovial sarcoma after the extremities. Case description: A 72-year-old male with left-sided nasal obstruction, epistaxis, loss of smell, and left eye proptosis. On anterior rhinoscopy, a proliferative mass was seen occupying the left nasal cavity and extending up to the floor of the nose. The mass was nonreducible, bled on touch, and friable on probing. Diagnostic nasal endoscopy showed a friable proliferative mass in the left nasal cavity extending up to the floor of the nose. In contrast Enhanced computed tomography (CECT) of the PNS, a heterogeneous soft tissue density with the central nonenhancing area is noted. Intraorbital extension showed erosion of the medial and inferior wall of the orbit and loss of fat plane with no involvement of orbital apex. An endoscopic biopsy of the sinonasal mass showed a spindle cell variant of synovial sarcoma which was confirmed by immunohistochemistry. The patient underwent concurrent radiotherapy as a treatment modality. Conclusion: The clinical presentation and management of synovial sarcoma of PNS are presented in this case report, along with a literature review. Though it commonly affects young individuals, it can also affect the elderly.