Oncocytomas are rare tumours, usually occurring in the salivary glands, but may very occasionally occur in other sites. The authors present a skull base oncocytoma as a rare cause of spontaneous epistaxis. Following diagnosis through imaging and intranasal biopsy, the patient opted for annual surveillance instead of active treatment and made a full recovery nonetheless. Skull base oncocytoma is a rare tumour that may result in otherwise common symptomatology. While excision is the mainstay of management, active surveillance may be a viable alternative for select patients.