We report a surgical case of acquired choanal stenosis. The patient was a 78-year-old woman with a chief complaint of nasal obstruction. Membrane choanal stenosis was found using fiberscopy and computed tomography. She was diagnosed with acquired membrane choanal stenosis due to syphilis and underwent endoscopic surgery. Postoperatively, however, the choana gradually developed stenosis. We performed endoscopic surgery again and placed a silicone stent and mucosa of the inferior turbinate on the choana. Recurrence has not been observed for 13 months after the surgery.