Hereditary hemorrhagic telangiectasia is an autosomal dominant disorder affecting blood vessels of the skin, mucous membrane and viscera. It is characterized by a clinical triad of multiple telangiectasia, recurrent hemorrhages and familial occurrence. In 80% of patients, epistaxia is the first presenting symptom. It can have a massive impact on the quality of life of those affected. Otolaryngologists should be familiar with this disease because of its potential systemic complication. Recently, we have experienced a 69 year old female complaining of melena and recurrent epistaxis for 20 years. Epistaxis was successfully managed with topical estrogen ointment.