Choanal atresia is a congenital absence of communication between the nasal cavity and nasopharynx. Bilateral Choanal Atresia usually present immediately after birth and in the neonatal period. We report an unusual case who presented at the age of twenty two years. This case was successfully managed by a transnasal approach. Choanal atresia should be considered as a rare diagnostic possibility in any patient who presents with total nasal obstruction and persistent mouth breathing.