Major haemoptysis is a very uncommon presentation of sarcoidosis inspite of the high rate and extent of pulmonary involvement in this disease. We report a 37-year-old Nigerian who presented with cough and weight loss and in whom haemoptysis was prominent. In developing tropical countries this mode of presentation is almost invariably due to pulmonary tuberculosis. In this case the haemoptysis was found to be due to ulcerations of nasopharyngeal granulomata due to sarcoidosis. Involvement of the upper respiratory tract in itself is an uncommon finding in sarcoidosis.