Pleomorphic adenoma rarely arises from the minor salivary glands. It has been reported at various sites where minor salivary glands are found, including the nasal cavity, oral cavity, nasopharynx, oropharynx, larynx, hypopharynx, trachea, and even lacrimal glands. In the nasal cavity, it usually arises from the minor salivary glands of septal mucosa. Intranasal pleomorphic adenoma may be misdiagnosed because it has high myoepithelial cellularity and fewer myxoid stroma compared to those arising from other sites. We report a case of pleomorphic adenoma in the nasal septum of an elderly woman who was treated for olfactory neuroblastoma 25 years ago. She presented with epistaxis from the left nostril for the last 4 months. Diagnostic nasal endoscopy showed a fleshy growth with crusting attached to the anterior nasal septum. She was evaluated elsewhere, and the histopathology report was suggestive of olfactory neuroblastoma. The slide review at our center was suggestive of pleomorphic adenoma, and immunohistochemistry (IHC) was positive for cytokeratin and p63 and negative for synaptophysin. Her case was discussed by a multidisciplinary team (MDT), and she underwent excision of the lesion with wide surgical margins using a lateral rhinotomy approach. Though pleomorphic adenoma from the septum is rare, it should be kept in mind while evaluating unilateral nasal obstruction/epistaxis in middle-aged patients.