Neuroendocrine tumours are epithelial neoplasms with predominant neuroendocrine differentiation. The nasal cavity and paranasal sinuses are rare locations for neuroendocrine carcinomas, and only a few related papers have been published in the literature to date. Here we present the case of a 64-year-old male with neuroendocrine carcinoma of the sphenoid sinus, along with the main MRI findings.