© 2018, ASEAN Neurological Association. All rights reserved.Various factors may lead to artefacts in many radiological examinations that are commonly used in daily clinical practice.1,2 There are some simple but important rules to obtain high quality X-ray images and proper diagnosis with the imaging guidance. Artefacts may result in difficulty in interpretation of images, unnecessary workup and even improper diagnosis.3 Hair artefact that were seen in young girls and female patients, has been rarely reported to be a problem.4 It has been reported on conventional radiographs of the skull, neck and even chest radiographs. Hair artefacts may be caused by structural features or style of hair bounding. In most cases these radiopacities were caused by braids, curls and, obviously synthetic hair braid extensions. Ponytail style hair artefact on radiography has been reported very rarely. We report here ponytail hair style artefact seen on paranasal sinus X-ray images of a young girl. The parents has consented to this report.