Nasal leech infestation is a rare etiology of epistaxis. Due to its insidious presentation and inconspicuous site of infestation, it is possible for the primary care setting to miss the diagnosis. We report a case of nasal leech infestation in an eight-year-old male child who was repeatedly treated for upper respiratory infection before finally being referred to the otorhinolaryngology clinic. We emphasize the importance of having a high index of suspicion and thorough history taking, especially of jungle trekking and hill water exposure in unexplained recurrent epistaxis.