Peri-orbital cellulitis is an infection involving soft tissues surrounding the eye, often a complication of upper respiratory infections, sinusitis, or trauma. While it is encountered in paediatric populations, cases associated with ipsilateral nasal wall and maxillary vestibule abscess are rare. Aim We present a case of unilateral peri-orbital cellulitis in a 12-year-old Indigenous female occurring as a complication of abscess in the ipsilateral nasal wall and maxillary vestibule. The unique clinical presentation emphasises the need for early recognition, appropriate management, and multidisciplinary approach in treating such cases. The study contributes to the limited literature on this presentation. Methods Retrospective radiological, biochemical, and clinical data was collected from EMR. The patient’s surgical and medical treatment is reported. Clinical and radiological images are included. Literature review was conducted using PubMed, Google Scholar, and Ovid. Case We describe a 12-year-old Aboriginal female who presented to the ED with 3 days of right headache and 1 day of progressive right cheek oedema and peri-orbital cellulitis. CT revealed hypodensity over the right nasal wall and maxillary vestibule, with peri-orbital fat-stranding and subperiosteal phlegmon. HM was admitted under ENT and had daily ophthalmology consults. Cheek oedema worsened despite 16 hours of IV Vancomycin, nasal decongestant, douche, and intranasal steroids. She underwent right mini-FESS, lacrimal duct probe, nasal wall I&D, and maxillary vestibule incision by OMFS. She received 2 weeks of IVABx under ID guidance. Peri-orbital cellulitis and cheek swelling improved following the procedure and associated medical management without complications. Conclusion This case highlights peri-orbital cellulitis presenting in atypical manner with associated lateral nasal wall and maxillary vestibule abscess. Prompt diagnosis and multidisciplinary approach were crucial for preventing complications.