Severe epistaxis after combined nasolacrimal duct probing and cardiac catheterisation in a one-year-old child is reported. The epistaxis followed streptokinase infusion given as treatment for femoral artery thrombosis secondary to cardiac catheterisation and necessitated nasal packing and blood transfusion. The authors recommend that probing not be undertaken in conjunction with another procedure if anticoagulant and/or thrombolytic agents are likely to be required.