Although paranasal sinus configuration has occasionally been the focus in analyses of the phylogenetic relationships of various primates, other elements of the region of the nasal fossa—in particular, the turbinals—have received far less attention. A preliminary study of Neanderthal cranial morphology revealed the presence of an apparently unique configuration of the lateral wall of the nasal cavity: namely, in the region in which in Homo sapiens the anterior extremity of the maxilloturbinal (also referred to as the inferior nasal concha) articulates with the internal surface of the maxilla along a relatively anteroposteriorly long and essentially horizontally oriented conchal crest, there exists a vertically oriented thickening that protrudes medially into the nasal cavity (Schwartz and Tattersall, Proc Natl Acad Sci USA 1996; 93:10852–10854). Subsequent citations of this report either claimed that this “medial projection” in Neanderthals is merely an enlarged maxilloturbinal or mistakenly identified as this structure the base of a maxilloturbinal that had fused to the lateral wall of the nasal cavity and subsequently broken off. In light of the potential significance that any novel configuration of the nasal complex architecture may have for elucidating hominid evolution, we present here a comparative overview of this region in fossil and extant large-bodied hominoids, and demonstrate that Neanderthals do indeed possess a configuration that is unique among hominids. Anat Rec, 291:1517–1534, 2008. © 2008 Wiley-Liss, Inc.