Nasal septum defects may have forensic relevance because they are associated with various mechanisms, including trauma and cocaine abuse. Like all human body tissues, the nasal septum may be affected by maggots' infestation during postmortem decomposition. Postmortem computed tomography (PMCT) can reveal small findings and related details. Three cases of early postmortem period and 2 cases of advanced decomposition, where external examination of the nasal cavities and PMCT revealed nasal septum defect, are presented. In the early postmortem period cases, the lesions' edges appeared smoother on PMCT, whereas in the advanced decomposed cases, the edges were irregular and maggots were infested. Postmortem computed tomography can detect nasal septum defects and may help differentiate the preexisting from the postmortem ones based on their edges' radiological appearance. Such findings may indicate possible chronic cocaine abuse (cocaine nose), trauma, or other nasal pathology. It is important to note that such defects may be altered or caused by advanced decomposition.