Hemangiopericytoma is an infrequent vascular tumor that rarely appears in the head and neck. The nasal cavity and the paranasal sinuses are most often involved. Four cases are added to the literature and some important features are stressed. The clinical presentation is aspecific. Diagnosis is made only by careful histological examination with special stainings (reticulin, immunohistochemistry with Ulex Europaeus) and gives an idea about the grading. Treatment with radical surgery, if possible, is effective while preoperative embolisation can reduce the risk of hemorrhage. The median follow-up of the present cases is only 3 years. During this period no recurrence was observed. We suggest that more radical resections can probably reduce the local recurrence rate. However lifetime clinical follow-up is warranted since late recurrences have been reported in almost half of the patients.