Ossifying fibroma of the middle turbinate is extremely rare. We report a case of psammomatoid juvenile ossifying fibroma (PsJOF) of the middle turbinate in an 18-year-old adolescent female along with its CT, MRI and pathologic features. PsJOF of the middle turbinate may present a well-demarcated, expansile, solidly enhancing mass with focal bony destruction, which may mimic various benign and malignant neoplasms of the sinonasal area. A combination of clinical, imaging and pathologic findings is prerequisite for establishing an accurate diagnosis.