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Foreign body in paranasal sinus is relatively uncommon in adults unlike in pediatrics cases. Majority of foreign bodies in the paranasal sinus are reported to be identified from maxillary sinus (75%), followed by frontal sinuses (18%), finally sphenoid and ethmoidal sinuses. A 34-year-old gentleman with 1-year-history of accidental dislodged screw during a dental surgery presented with unilateral nasal symptoms. To our surprise, computed tomography paranasal sinus revealed opacity in the right sphenoid sinus when the initial screw was missing from the left side. Albeit a rare entity, awareness amongst physician on migration of foreign body is crucial as it may ascribe to devastating consequences.