<p>The nose apart from its varied functions, also bears aesthetic importance to an individual. Granulomatous disorders like Rhinoscleroma which is known for its endonasal preponderance, can rarely mutilate the external nose. The present case discusses the management of a difficult case of Rhinoscleroma in a geriatric patient which involved the lower nose and upper lip. After biopsy confirmation of the disease, medical line of treatment with Rifampicin and topical acriflavine was initiated. The resultant amalgamated lower third of nose and upper lip was further corrected by aesthetic surgery for columella, nasal base, nostrils and upper lip. This case highlights that despite being in the modern era, Rhinoscleroma is still prevalent in certain pockets of tropical countries and due to poor socioeconomic status, and psychological stigma, patients do not approach for care. Case reports on reconstructive surgery and its success in particular to Rhinsocleroma are few in Indian literature. With a keen suspicion, and patience, this disease can be managed well.</p>