Leeches are an unusual cause of epistaxis and haemoptysis that should be considered in places with poor access to water. In this case report, we present a 7-year-old girl previously mismanaged as bacterial pharyngitis but later discovered to be a leech in the pharynx. She had ingested a leech from a spring that caused a foreign body sensation in the throat, frequent throat clearing, epistaxis, haemoptysis, and mild anaemia. The 3cm long leech was successfully removed by using Tilley forceps without any anaesthesia and with complete resolution of symptoms.