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Delusional Disorder is a rare syndrome mainly characterized by the presence of non-bizarre delusions (prevalence 0.03%). The somatic subtype, in which delusions are based on the presence of a physical disease, is also known as monosympomatic hypochondriacal psychosis. These cases reported have been found interesting because of unusual nature of their somatic delusion and significant improvement provided by treatment; and is discussed in terms of similarity with Olfactory Reference Syndrome (ORS) and differential diagnosis. Mrs. T. was 37-year-old, divorced, housewife with two children. Patient claimed that she felt embarrassed due to the involuntary sexual impression radiated from her face, especially her cheek. Since she was not able to look directly at someone without shame, she started wearing hijab to conceal her face and alienated herself from her social environment. While she was facing financial problems, her problems emerged immediately after she had exploding cucumber (Ecballium elaterium) for the treatment of her sinusitis. She suggested that aspirating this material from her nose resulted in poisoning her brain. Subsequently, her nerves have been out of control, she claimed, and this material could still emit from her sweat. She mentioned the sexual impression emitted from her face had led people to condemn her. Her sister, unlike her, could not detect the alteration in her face when the sexual impression was in motion. She told that her relatives were fed up with her problems. She claimed this situation has lasted all day long and less problematic while she was alone. However, she could hardly sleep and she covered her face in order not to seduce someone in her sleep. Although she was treated with a number of antipsychotic and antidepressant drugs earlier, she was not on medication nor having remission phases. Being diagnosed with delusional disorder (somatic type), she was medicated with aripiprazole 15 mg/day and venlafaxine 37.5 mg/day. Doses of the drugs were incrementally increased to 30 mg/day for the former and 150 mg/day for the latter. Within two months, there has been significant decrease in her avoidance related to delusions and embarrassment whereas insight about her situation was not developed. BPRS scores were 25, 13 and 6. ORS, which is characterized by delusions of emitting unpleasant odors may also cause feelings of intense shame and therefore lead to avoidance from social interaction similar to this case; but the delusional content described by this patient is far of being the same. Delusional disorder of somatic subtype is to be distinguished by the clinician from other psychiatric conditions such as body dysmorphic disorder, hypochondriasis, overvalued ideas and obsessions. In treatment, pimozide and some other antipsychotics appear to show strongest evidence of good results and SSRIs seem effective for accompanying depressive symptoms. In our case, a significant clinical improvement has been provided within a few months by the combination of venlafaxine and aripiprazole.