Congenital nasal anomalies are uncommon and their clinical significance can vary depending on the structures involves. These anomalies are broadly categorised into hypoplastic, hyperplastic/duplication, clefts and nasal masses. The lower lateral cartilages (LLC) define the nasal tip as well as function of the external nasal valve. Typically, these cartilages develop as paired single units, but developmental anomalies can result in the presence of extra or duplicated cartilages, leading to both functional and aesthetic concerns. We present the case of an 18 month female with a duplication lower lateral cartilage masquerading as a nasal mass. Initially diagnosed as a nasal cyst on a 20 week prenatal scan, post-natal examination later showed a 5mm left nasal tip mass. An otherwise healthy child, the patient had no nasal obstruction or functional symptoms. Further characterisation with an MRI showed a 5mm mixed T2 hyper and hypointense left nasal tip lesion without intracranial or intranasal involvement. After 12 months of monitoring, the mass remained stable in size relative to other nasal structures but became significantly more defined leading to a recommendation for surgery. At 18 months, the patient underwent an open rhinoplasty approach to excision revealing, not a cyst, but a folded duplicate left lower lateral cartilage. The cartilage was mobilised, unfolded and trimmed. Post-operatively the patient is being monitored jointly between paediatric plastic surgery and ENT teams with the view for definitive surgery in the future. An uncommon case of lower lateral cartilage duplication, we highlight the diagnostic and management challenging associated with paediatric congenital nasal anomalies, in this case a duplication lower lateral cartilage.