Cholesterol granulomas, also termed chocolate cysts are chronic benign inflammatory lesions that most commonly form in the petrous apex of the temporal bone. Comprised of cholesterol crystals and foreign body giant cells they occur as a result of a chronic local inflammatory response. Cholesterol granulomas are a relatively uncommon entity and are infrequently reported in the paranasal sinuses. We present the case of a 53 year old female with a right frontal sinus cholesterol granuloma. Initially presenting with a two month history of right sided frontal headache. CT sinuses showed a 4.3 x 3.1 x 3.4cm right frontal sinus lesion with erosion of the inner table and mass effect on the right frontal lobe. MRI revealed a T1 and T2 hyperintense lesion with secondary right frontal dural enhancement. Endoscopic surgical resection was performed with stereotactic guidance. The frontal sinuses were addressed with a Draf III/endoscopic modified Lothrop approach revealing the right frontal sinus cyst. The cyst lining and thick yellow contents were evacuated and sent for histopathology. Findings of low grade chronic inflammatory changes surrounding an aggregate of cholesterol crystals confirmed the diagnosis of cholesterol granuloma. Cholesterol granulomas, although most commonly seen in the petrous apex of the temporal bone may rarely present in the paranasal sinuses. This is an uncommon case of a frontal sinus cholesterol granuloma causing mass effect on the right frontal lobe.