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Objective: To report the first case of primary bilateral antro-choanal polyps in the elderly age group.   Methods:        Design: Case Report        Setting: Tertiary Government Hospital        Patient: One   Result: A 60-year-old, non-allergic female with progressive bilateral nasal obstruction was subsequently diagnosed with bilateral antro-choanal polyps. Endoscopic sinus surgery was performed and the patient remained asymptomatic on one year follow-up.   Conclusion: Antro-choanal polyps can occur bilaterally in the elderly age group. To the best of our knowledge, this is the first reported case of primary bilateral antro-choanal polyps in an elderly female.   Keywords: antro-choanal polyp; bilateral; elderly; female