The juvenile nasopharyngeal fibroma is one of the less frequently found tumors and its propagation towards the skull cavity is very rare. The etiopathogeny of this process is controversial. Many authors do not consider it a true beningn neoplasm, but a reactive hyperplasia of the collagen tissue caused by a genetical or hormonal stimulus. A case of juvenile nasopharyngeal fibroma in a 15-year-old male is reported. The tumor extended to the anterior and middle fossae. The patient failed to show any clinical or laboratory sign of hyperestrogenism. The operation was performed in two stages: firstly the removal of the intracranial portion of the growth was performed through a fronto-temporal craniotomy; one week later, the remaining was excised through a trasmaxillar approach. One year after the surgical treatment the patient was re-evaluated and no clinical or radiological signs of the tumor recurrence were evidenced.