Mucosal leishmaniasis (ML) is an uncommon complication of a disease seen primarily in the developing world. A 31-year-old previously healthy man presented with six months of nasal congestion, throat pain, hoarseness, and intermittent dysphagia and odynophagia. The leishmania culture was positive, and PCR testing was consistent with Leishmania braziliensis infection. He was treated with liposomal amphotericin B therapy for three weeks. He resolved symptomatically after therapy. This case highlights the necessity of obtaining accurate travel and social history and the often delayed presentation of mucosal leishmaniasis.